Risk Factors for Skull Base Spontaneous Cerebrospinal Fluid Leak in Patients with Idiopathic Intracranial Hypertension: A Multinational Database Study.

Publication/Presentation Date

12-1-2026

Abstract

OBJECTIVES: Skull base spontaneous cerebrospinal fluid leaks (sCSF leaks) represent a distinct cohort of patients with idiopathic intracranial hypertension (IIH). Patients with sCSF leaks often have comorbidities that are modifiable risk factors. In this study, we compare demographics and treatment modalities between IIH patients with sCSF leaks (IIHwL) and IIH patients without skull base sCSF leaks (IIHwoL), and characterize the risk of CSF leak development in IIH patients.

DESIGN: Retrospective cohort study.

SETTING: Electronic medical record data from the TriNetX Research database.

PARTICIPANTS: Patients > 18 years old with a diagnosis of IIHwL and patients with a diagnosis of IIHwoL.

MAIN OUTCOME MEASURES: Baseline demographic data and comorbidities were compared and sCSF leak risk evaluated. Shunt placement and medication use were compared for 3 years following diagnosis.

RESULTS: A total of 1,277 IIHwL patients and 90,074 IIHwoL patients were analyzed. IIHwL patients had higher rates of comorbid conditions (

CONCLUSION: These findings strengthen the association between IIH as a contributor to sCSF leak risk and imply that longer-standing IIH further increases this risk. This is the first study to identify smoking as a potential sCSF leak risk factor and to both describe and quantify the rate of risk increase for sCSF leak in IIH patients.

Volume

87

Issue

6

First Page

726

Last Page

732

ISSN

2193-6331

Disciplines

Medicine and Health Sciences

PubMedID

42979636

Department(s)

Administration and Leadership, Department of Surgery

Document Type

Article

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