Latest news with #Neurosurgery&Psychiatry
Los Angeles Times
23-06-2025
- Health
- Los Angeles Times
Why Weight Loss is the First Treatment for Idiopathic Intracranial Hypertension
Idiopathic Intracranial Hypertension (IIH) is a puzzling but increasingly common neurological condition that mimics the signs of a brain tumor—without one actually being present. IIH is also known as benign intracranial hypertension and pseudotumor cerebri (called pseudotumor cerebri). It is defined by increased intracranial pressure (ICP) without a known cause, different from others like portal hypertension. Characterized by elevated intracranial pressure (ICP) and symptoms like persistent headaches, visual changes, and pulsatile tinnitus, IIH mostly affects women of childbearing age who are overweight or obese. These groups are at higher risk, and risk factors include obesity and recent weight gain. Vision problems are among the most important clinical features of IIH. While the exact cause remains elusive, the condition is idiopathic, meaning there is no known cause, despite the presence of risk factors and a clear clinical presentation. One thing is clear: weight loss isn't just helpful—it's essential. It's the only intervention proven to modify the disease course, offering relief from symptoms and a protective effect against vision loss [1] [4]. At its core, IIH is defined by increased pressure inside the skull without a detectable cause, such as a mass or hydrocephalus. Diagnostic criteria for IIH include clinical features, brain imaging to rule out an intracranial mass, and measurement of cerebrospinal fluid pressure via lumbar puncture (spinal tap). Patients often present with: Other symptoms can include neck or back pain, dizziness, and cognitive changes. Though the mechanisms aren't fully understood, there's a well-established link between IIH and obesity. The theory is that excess body weight may impair venous drainage from the brain, leading to cerebrospinal fluid (called cerebrospinal fluid) buildup around the brain and spinal cord. Venous sinus stenosis and abnormal venous pressure may contribute to increased intracranial pressure in IIH. This connection is why weight reduction remains the foundation of treatment [1] [4]. IIH occurs most often in women of childbearing age, but can affect others as well. The 2018 Consensus Guidelines published in the Journal of Neurology, Neurosurgery & Psychiatry make it unequivocally clear: weight loss is the most effective strategy for managing IIH [1] [4]. Even a modest reduction in weight—just 5% to 10% of a person's total body weight—has been shown to significantly decrease intracranial pressure, relieve headaches, and improve vision [5]. Women who are more than 20% above their ideal body weight are at increased risk for IIH, so losing weight to reach or approach ideal body weight is a key goal in management. Weight loss isn't a one-size-fits-all recommendation. It's a structured, multidisciplinary effort that often involves: For patients with a BMI over 30 kg/m², early intervention is critical. Experts recommend a compassionate, consistent approach that respects the psychosocial complexities of weight and body image [1]. Acetazolamide is typically the first drug prescribed. It works by inhibiting carbonic anhydrase, which reduces the production of CSF. Topiramate offers a double advantage. It not only lowers CSF production but also helps with weight loss—a bonus in IIH management. Surgery is usually a last resort, reserved for patients who have: Surgical options include: Each of these procedures carries potential risks, so decisions should be made in consultation with neurology, neurosurgery, and ophthalmology teams. Repeated lumbar punctures are now rarely used as a long-term treatment due to rapid reaccumulation of CSF. Some individuals have all the classic symptoms of IIH—especially headaches—but without any optic nerve swelling. This subtype, known as IIH without papilledema (IIHWOP), demands a slightly different treatment approach [2]. Consistent, structured follow-up is essential in IIH management. Most patients require: These assessments guide decisions about medication adjustment, weight loss effectiveness, and the need for escalated care. Ongoing collaboration between neurology and ophthalmology is vital to protecting long-term vision. Pediatric ophthalmology plays a crucial role in monitoring and managing IIH in children, ensuring early detection and specialized care for pediatric patients. While lowering ICP can help reduce headaches, it's not always enough. Many patients continue to experience migraines or tension-type headaches, even after their pressure normalizes. Treatment may include: Idiopathic Intracranial Hypertension can feel overwhelming for patients and providers alike, but there's good news: for most, sustainable weight loss truly changes the game. Combined with medical therapy and ongoing monitoring, lifestyle changes offer a tangible path to better health, fewer symptoms, and long-term vision preservation. While surgery plays a role in some cases, it's weight management that remains the beating heart of effective IIH care. [1] Mollan, S. P., Davies, B., Silver, N. C., Shaw, S., Mallucci, C. L., Wakerley, B. R., Krishnan, A., Chavda, S. V., Ramalingam, S., Edwards, J., Hemmings, K., Williamson, M., Burdon, M. A., Hassan-Smith, G., Digre, K., Liu, G. T., Jensen, R. H., & Sinclair, A. J. (2018). Idiopathic intracranial hypertension: consensus guidelines on management. Journal of neurology, neurosurgery, and psychiatry, 89(10), 1088–1100. [2] Thurtell M. J. (2019). Idiopathic Intracranial Hypertension. Continuum (Minneapolis, Minn.), 25(5), 1289–1309. [3] Ko M. W. (2011). Idiopathic intracranial hypertension. Current treatment options in neurology, 13(1), 101–108. [4] Kanagalingam, S., & Subramanian, P. S. (2018). Update on Idiopathic Intracranial Hypertension. Current treatment options in neurology, 20(7), 24. [5] Celebisoy, N., Gökçay, F., Sirin, H., & Akyürekli, O. (2007). Treatment of idiopathic intracranial hypertension: topiramate vs acetazolamide, an open-label study. Acta neurologica Scandinavica, 116(5), 322–327. [6] Piper, R. J., Kalyvas, A. V., Young, A. M., Hughes, M. A., Jamjoom, A. A., & Fouyas, I. P. (2015). Interventions for idiopathic intracranial hypertension. The Cochrane database of systematic reviews, 2015(8), CD003434.
CNBC
03-05-2025
- Health
- CNBC
Brain health experts' top 3 tips for lowering your risk of dementia, stroke and depression—all at the same time
There are certain lifestyle choices that can lower your risk of developing dementia, stroke and depression later in life, according to a recent study published in the Journal of Neurology, Neurosurgery & Psychiatry. "At least 60% of stroke, 40% of dementia and 35% of late-life depression are attributable to modifiable risk factors," the study found. It turns out that people who've had a stroke before tend to develop depression or dementia, and the same is true in the reverse, Dr. Sanjula Singh, the lead author of the study, told The New York Times. Singh is also a principal investigator at the Brain Care Labs at Massachusetts General Hospital. Here are the top three practices that experts found have the greatest effect on your chances of staving off these brain conditions. If you don't know where to start, you can take a quiz to get your Brain Care Score, which is a system created at Mass General to measure how healthy your brain is. To receive your score, you answer questions about your lifestyle choices like your blood pressure levels, dietary habits and sleep quality. Having a higher Brain Care Score is associated with having a lower risk of dementia, depression and stroke, according to a study published in Frontiers in Psychiatry. And even lower scores can get a boost by working on the areas of improvement that are suggested in your results, according to Dr. Jonathan Rosand, a professor of neurology at Harvard University who treats patients with head trauma, spinal cord injuries and strokes at Mass General. "The key is to take the score as a guide and just use it for yourself to improve it, however you want to start improving it," Rosand told CNBC Make It in December of 2024. It's important to consult with a physician if you notice any early signs or symptoms of depression, stroke or dementia. "It's really helpful when you go to the doctor if you bring the score with you and you've already decided, 'This is what I'd like to work on.'" And make sure to consult your own medical professional regarding your specific health needs.
Yahoo
02-04-2025
- Health
- Yahoo
Four potential side-effects of cholesterol-lowering drugs statins
In the early Noughties, "cholesterol" became a bit of a buzzword, with campaigns and advertisements telling us we should care about it – and seek to maintain healthy levels. And although its prominence in conversation has died down somewhat in recent years, its importance is no less real, with 59% of people in the UK experiencing raised cholesterol in 2021. High levels of cholesterol was most evident in those aged 45 and 64 (72%) and among adults aged 16 to 33, men (53%) were more likely than women (46%) to have raised levels. Now, a new study has also linked reduced levels of bad cholesterol with curbing the risk of dementia, finding that people with low-density lipoprotein (LDL-C) in their blood are 26% less likely to develop dementia and Alzheimer's disease. It also looked at the use of statins – cholesterol-lowering medications – and found them to provide an "additional protective effect" against the condition. Here, we take a look at what statins are, how they work – and the potential side-effects and benefits of the drug. A group of medicines that help lower the level of LDL cholesterol – "bad cholesterol" – in the blood, statins are designed to reduce the production of it inside the liver. The drugs are normally prescribed to those with potentially dangerous levels of LDL-C, which, in turn, can lead to the hardening and narrowing of the arteries and result in cardiovascular disease or atherosclerosis. Coming in tablet form, statins are taken once daily, but the dose will depend on your medical needs. This dosage may also change over time, depending on what your GP deems necessary. Most people have to continue taking statins throughout their life once they have been prescribed them. Headaches Dizziness Nausea Digestive problems, such as indigestion, diarrhoea or constipation Muscle pain Problems with sleep Low blood platelet count Feeling tired or physically weak Muscle damage – This usually only happens when statins are taken in combination with other medication Loss of sensation or tingling in the nerve endings Tendon problems Hair loss Memory problems Skins irritation Loss of sex drive Erectile dysfunction Being sick Liver damage In addition to the 2025 study published in the Journal of Neurology, Neurosurgery & Psychiatry (outlined above), a 2016 study published by the same journal also linked statins to a lower risk of dementia and Alzheimer's. Looking at 400,000 Medicare beneficiaries who used the drugs, the research found that men in the group who had taken the medication regularly for two years had a 12% lower risk of developing Alzheimer's. Various studies have also looked at the impact statins have on cancer risks, but the results have been inconsistent and there's no conclusive answer right now. More research needs to be done to gauge whether statins can, indeed, lower the risk of certain cancers. The drugs have also been found to reduce inflammation and irritation, and the exacerbation of atherosclerosis, which is a major cause of coronary artery disease (CAD). Research published by Nature Communications in 2019 discovered a new link between statins and immune systems. It found that by using medications like statins, they could modify cell responses in the lab. Professor Andrew Cope, lead investigator of the study, said: "We think that our findings could explain why people taking statins are better at fighting influenza, and why patients have better outcomes for some types of cancer." Read more about health conditions: Seven health conditions you can visit your pharmacy for (Yahoo Life UK, 4-min read) Seven chronic health conditions you've (probably) never heard of (Yahoo Life UK, 6-min read) Six crucial things to learn about your health - before it's too late (Yahoo Life UK, 7-min read)
Yahoo
02-04-2025
- Health
- Yahoo
Four potential side-effects of cholesterol-lowering drugs statins
In the early Noughties, "cholesterol" became a bit of a buzzword, with campaigns and advertisements telling us we should care about it – and seek to maintain healthy levels. And although its prominence in conversation has died down somewhat in recent years, its importance is no less real, with 59% of people in the UK experiencing raised cholesterol in 2021. High levels of cholesterol was most evident in those aged 45 and 64 (72%) and among adults aged 16 to 33, men (53%) were more likely than women (46%) to have raised levels. Now, a new study has also linked reduced levels of bad cholesterol with curbing the risk of dementia, finding that people with low-density lipoprotein (LDL-C) in their blood are 26% less likely to develop dementia and Alzheimer's disease. It also looked at the use of statins – cholesterol-lowering medications – and found them to provide an "additional protective effect" against the condition. Here, we take a look at what statins are, how they work – and the potential side-effects and benefits of the drug. A group of medicines that help lower the level of LDL cholesterol – "bad cholesterol" – in the blood, statins are designed to reduce the production of it inside the liver. The drugs are normally prescribed to those with potentially dangerous levels of LDL-C, which, in turn, can lead to the hardening and narrowing of the arteries and result in cardiovascular disease or atherosclerosis. Coming in tablet form, statins are taken once daily, but the dose will depend on your medical needs. This dosage may also change over time, depending on what your GP deems necessary. Most people have to continue taking statins throughout their life once they have been prescribed them. Headaches Dizziness Nausea Digestive problems, such as indigestion, diarrhoea or constipation Muscle pain Problems with sleep Low blood platelet count Feeling tired or physically weak Muscle damage – This usually only happens when statins are taken in combination with other medication Loss of sensation or tingling in the nerve endings Tendon problems Hair loss Memory problems Skins irritation Loss of sex drive Erectile dysfunction Being sick Liver damage In addition to the 2025 study published in the Journal of Neurology, Neurosurgery & Psychiatry (outlined above), a 2016 study published by the same journal also linked statins to a lower risk of dementia and Alzheimer's. Looking at 400,000 Medicare beneficiaries who used the drugs, the research found that men in the group who had taken the medication regularly for two years had a 12% lower risk of developing Alzheimer's. Various studies have also looked at the impact statins have on cancer risks, but the results have been inconsistent and there's no conclusive answer right now. More research needs to be done to gauge whether statins can, indeed, lower the risk of certain cancers. The drugs have also been found to reduce inflammation and irritation, and the exacerbation of atherosclerosis, which is a major cause of coronary artery disease (CAD). Research published by Nature Communications in 2019 discovered a new link between statins and immune systems. It found that by using medications like statins, they could modify cell responses in the lab. Professor Andrew Cope, lead investigator of the study, said: "We think that our findings could explain why people taking statins are better at fighting influenza, and why patients have better outcomes for some types of cancer." Read more about health conditions: Seven health conditions you can visit your pharmacy for (Yahoo Life UK, 4-min read) Seven chronic health conditions you've (probably) never heard of (Yahoo Life UK, 6-min read) Six crucial things to learn about your health - before it's too late (Yahoo Life UK, 7-min read)
