A 10-Year Experiences in Pediatrics with Idiopathic Intracranial Hypertension: Prevalence of Preterm Birth, Delivery Methods, and the Correlation Between Preterm Birth and Delivery Type with the Development of Idiopathic Intracranial Hypertension

Background: Idiopathic intracranial hypertension (IIH) refers to a condition where intracranial pressure increases without an identifiable cause. If left untreated, it can become life-threatening. Identifying risk factors is crucial for timely intervention and follow-up care. This study aims to evaluate the prevalence of IIH in preterm children, investigate the type of delivery, and explore the relationship between delivery type, preterm birth, and increased intracranial pressure in these patients, with the goal of identifying potential risk factors for better management and follow-up. Methods: This retrospective study was approved by the Ethics Committee of Tehran Children's Medical Center and included patients diagnosed with IIH referred to the center from January 2014 to January 2024. Patient records were reviewed and categorized into four groups based on the revised Friedman criteria. Neuroimaging findings, assessed by a neuroradiologist, included empty sella, globe flattening, perioptic subarachnoid space distension, and transverse venous sinus stenosis. Demographic data, clinical symptoms, gestational age (preterm vs. term), and delivery type (NVD vs. cesarean section) were documented. Inclusion criteria required elevated lumbar CSF opening pressure with no other identifiable causes of intracranial hypertension. Written consent was obtained from all participants or their guardians. Results: In this study, 119 patients (mean age: 8.91 ± 4.26 years; 22.9% female) were examined, with an average BMI of 20.37 ± 6.06. Clinical symptoms included headaches (61.3%), nausea/vomiting (34.5%), diplopia (27.7%), and blurred vision (25.2%). Preterm births accounted for 37.81%. No significant correlations were found between CSF pressure and age, gender, BMI, symptoms, gestational age, or delivery type. Patients with papilledema were significantly older (10.05 vs. 8.40 years). Neuroimaging findings included transverse venous sinus stenosis (5.04%) and other abnormalities at low frequencies. Conclusion: This study found no significant association between the type of delivery or gestational age and the development of IIH. However, IIH prevalence was higher in patients born preterm or via cesarean section. The study suggests that reducing cesarean section and preterm birth rates could help lower IIH prevalence. Increasing natural deliveries and ensuring regular follow-ups for preterm infants may further reduce IIH incidence.