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November 11, 2014; 83 (20) Article

Bariatric surgery as a possible risk factor for spontaneous intracranial hypotension

Wouter I. Schievink, Aimee Goseland, Scott Cunneen
First published October 22, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000985
Wouter I. Schievink
From the Departments of Neurosurgery (W.I.S., A.G.) and Surgery (S.C.), Cedars-Sinai Medical Center, Los Angeles, CA.
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Aimee Goseland
From the Departments of Neurosurgery (W.I.S., A.G.) and Surgery (S.C.), Cedars-Sinai Medical Center, Los Angeles, CA.
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Scott Cunneen
From the Departments of Neurosurgery (W.I.S., A.G.) and Surgery (S.C.), Cedars-Sinai Medical Center, Los Angeles, CA.
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Citation
Bariatric surgery as a possible risk factor for spontaneous intracranial hypotension
Wouter I. Schievink, Aimee Goseland, Scott Cunneen
Neurology Nov 2014, 83 (20) 1819-1822; DOI: 10.1212/WNL.0000000000000985

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Abstract

Objective: To evaluate a possible link between bariatric surgery and spontaneous intracranial hypotension.

Methods: The frequency of bariatric surgery was examined in a group of 338 patients with spontaneous intracranial hypotension and compared with a group of 245 patients with unruptured intracranial aneurysms.

Results: Eleven (3.3%) of the 338 patients with spontaneous intracranial hypotension had a history of bariatric surgery compared with 2 (0.8%) of the 245 patients with intracranial aneurysms (p = 0.02). Among the 11 patients with spontaneous intracranial hypotension after bariatric surgery, the mean age at the time of bariatric surgery was 40.8 years (range, 26–53 years) and the mean age at the time of onset of spontaneous intracranial hypotension was 45.6 years (range, 31–59 years). Weight at the time of bariatric surgery ranged from 95 to 166 kg (mean, 130 kg) (body mass index range: 34.9–60.1 kg/m2; mean: 44.6). Weight at the time of onset of symptoms of spontaneous intracranial hypotension ranged from 52 to 106 kg (mean, 77.5 kg) (body mass index range: 19.2–32.1 kg/m2; mean: 26.4). The mean weight loss from bariatric surgery to onset of spontaneous intracranial hypotension was 52.5 kg (range, 25–98 kg). Time interval from bariatric surgery to onset of symptoms of spontaneous intracranial hypotension ranged from 3 to 241 months (mean, 56.5 months).

Conclusions: This case-control study shows that bariatric surgery is a potential risk factor for spontaneous intracranial hypotension.

GLOSSARY

BMI=
body mass index

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received March 18, 2014.
  • Accepted in final form August 8, 2014.
  • © 2014 American Academy of Neurology
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