Document Type

Abstract

Publication Date

2-11-2026

Academic Year

2025-2026

Comments

Presented at the 2026 Scholarly Inquiry (SI) Research Project Symposium.

Abstract

Introduction/Purpose: Body mass index (BMI), venous sinus pressure (VSP), and craniospinal elastance each correlate with lumbar puncture opening pressure (LP OP) in idiopathic intracranial hypertension (IIH), but their mechanistic interactions remain unclear. This study examined how these factors jointly influence OP, hypothesizing that BMI has a stronger positive association with intracranial pressure (ICP) when elastance is elevated.

Methods: A single-center retrospective review was conducted to identify patients who underwent venous manometry (8/2021–11/2025) followed by LP within 7 days. VSPs were recorded at the torcula (TP) and sigmoid/jugular (SIJ) sinuses. Elastance was calculated as (OP – closing pressure)/volume of CSF removed. A generalized linear model (Gaussian identity; scaled center) assessed relationships among LP OP, BMI, TP, elastance, and the BMI×elastance interaction while controlling for age and sex, using a random intercept and hierarchical removal of nonsignificant interactions.

Results/Conclusions: Of 135 screened patients, 28 refractory IIH patients (92.9% female; BMI 38.2±9.5) met criteria. Racial distribution included 50.0% Caucasian, 39.3% African American, and 10.7% other groups. Mean LP OP was 32.7±14.1cmH₂O; mean TP 30.0±15.8mmHg; mean SIJ 15.6±6.5mmHg; and mean elastance 0.784±0.377cmH₂O/mL. TP, elastance, and the BMI×elastance interaction were significant predictors of LP OP. Notably, BMI’s effect on LP OP became significantly stronger as elastance increased. These findings suggest that craniospinal elastance modulates how BMI contributes to ICP elevation in IIH, providing a potential explanation for heterogeneity in pressure responses among patients with similar BMI. Larger prospective studies are needed to validate these interactions and clarify their relevance to IIH pathophysiology and clinical management.

Additional Files
Wang_Rachel_poster.pdf (1772 kB)

Language

English

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