Hindawi Publishing Corporation
Scienti�ca
Volume 2012, Article ID 708042, 4 pages
http://dx.doi.org/10.6064/2012/708042
Research Article
The Prevalence of Polycystic Ovary Syndrome in Women with
Idiopathic Intracranial Hypertension
Inbal Avisar,
1, 2
Dan D. Gaton,
1, 2
Hirsch Dania,
2, 3
and Hadas Stiebel-Kalish
1, 2
1
Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, 49100 Petah Tiqva, Israel
2
Sackler Faculty of Medicine, Tel Aviv University, 69918 Tel Aviv, Israel
3
Department of Endocrinology, Rabin Medical Center, Beilinson Campus, 49100 Petah Tiqva, Israel
Correspondence should be addressed to Inbal Avisar; avisar.inbal@gmail.com
Received 27 May 2012; Accepted 1 July 2012
Academic Editors: M. F. Cordeiro and A. O. L. Wong
Copyright © 2012 Inbal Avisar et al. is is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose. e purpose of this study is to re-evaluate whether the prevalence of polycystic ovary syndrome (PCOS) amongst women
with idiopathic intracranial hypertension (IIH) is higher than in the general population using the NIH criteria. Methods. We
included all consecutive women with IIH of child-bearing age seen at a hospital-based neuro-ophthalmology clinic between the
years 2000�2005. All consenting women included in this study �lled-out a screening questionnaire aimed at identifying women
at risk for PCOS. e endocrinologist examined each patient suspect of PCOS as well as their biochemical results and diagnosed
PCOS according to NIH criteria. e prevalence of PCOS in these women with IIH was compared with the reported prevalence
of PCOS in the general population. Results. Out of 58 women with IIH who completed the study, de�nite PCOS was diagnosed in
nine women (9/58; 15.5%). We found a signi�cantly higher prevalence of PCOS using the NIH criteria among the IHH study group
(15.5%, ) compared to the general population (8.7%). Conclusions. e prevalence of PCOS is higher among patients with
IHH, compared to the general population. We suggest a novel screening questionnaire to aid in the identi�cation of women with
IIH at risk for PCOS.
1. Introduction
e etiology of idiopathic intracranial hypertension (IIH),
also known as pseudotumor cerebri, is unclear. IIH occurs
mainly in young obese women. Underlying and associ-
ated endocrinological abnormalities have been reported in
numerous studies [1, 2].
Diagnostic criteria for IIH include signs and symptoms
that re�ect intracranial pressure (e.g., papilledema), doc-
umented elevated intracranial pressure with normal CSF
composition, no evidence of mass, structural, or vascular
lesion on MRI, MR venography, or contrast-enhanced CT,
and no other cause of intracranial hypertension [1, 3].
Treatment is aimed mainly to prevent visual compromise and
alleviate headaches. Acetazolamide, weight loss, and correc-
tion of underlying risk factors, including endocrinological
abnormalities, are recommended. Some cases are refractory
to medical intervention and require surgery (fenestration of
the optic-nerve sheath or lumboperitoneal shunting) [4, 5].
Women with IIH need all the help we can offer to aid them in
�ghting obesity and endocrinological abnormalities in order
to prevent visual compromise.
e polycystic ovary syndrome (PCOS) includes truncal
obesity, menstrual irregularities, hyperandrogenism with
hirsutism, acne, alopecia, and multiple ovarian follicular
cysts. PCOS is characterized by several endocrine abnormal-
ities, including increased conversion of androstenedione to
estrone by stromal cells within adipose tissue [6, 7]. Insulin
resistance is more common in PCOS [8, 9].
ere are two main accepted systems for de�ning PCOS.
According to the NIH criteria, two conditions have to be met:
chronic anovulation and clinical or biochemical evidence
of hyperandrogenism. Recently, the European Society for
Human Reproduction and Embryology and the American
Society for Reproductive Medicine (ESHRE/ASRM) sug-
gested new criteria for the de�nition of PCOS. is is now
de�ned as the presence of any two of the following conditions:
(i) polycystic ovaries; (ii) oligo-/anovulation; (iii) clinical or