{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T17:59:23Z","timestamp":1785347963693,"version":"3.55.0"},"reference-count":23,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sci.","Brain Sciences"],"abstract":"<jats:p>Background: Idiopathic intracranial hypertension without papilledema (IIHWOP) is increasingly recognized, but its clinical characteristics and treatment-related outcomes remain insufficiently defined. This study aimed to compare patients with idiopathic intracranial hypertension (IIH) with and without papilledema. Methods: This retrospective observational cohort study included adult patients diagnosed with IIH at a tertiary neurology and referral center. Demographic, clinical, neuro-ophthalmologic, radiological, lumbar puncture, and treatment-related characteristics were compared according to papilledema status. Results: Among 123 patients with IIH, 83 (67.5%) had papilledema, and 40 (32.5%) had IIHWOP. Age, sex distribution, body mass index, lumbar puncture opening pressure, and most neuroimaging findings were similar between groups. In exploratory between-group analyses, photophobia [35\/40 (87.5%) vs. 55\/83 (66.3%), p = 0.023], phonophobia [35\/40 (87.5%) vs. 56\/83 (67.5%), p = 0.031], and nausea\/vomiting [20\/40 (50.0%) vs. 17\/83 (20.5%), p = 0.002] were more frequent among patients with IIHWOP than among those with papilledema. Diabetes mellitus was also more frequent in the IIHWOP group [8\/40 (20.0%) vs. 5\/83 (6.0%), p = 0.040]. Treatment persistence did not differ significantly between groups (log-rank p = 0.604). In multivariable analysis, papilledema was associated with higher odds of failure to achieve a complete treatment response, whereas higher lumbar puncture opening pressure was associated with lower odds of treatment nonresponse. Conclusions: Exploratory analyses suggested that patients with IIHWOP may exhibit a different clinical presentation characterized by more prominent migraine-like symptoms. However, these exploratory observations require confirmation in prospective studies.<\/jats:p>","DOI":"10.3390\/brainsci16080798","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:57:28Z","timestamp":1785254248000},"page":"798","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Idiopathic Intracranial Hypertension with and Without Papilledema: A Comparative Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9719-2330","authenticated-orcid":false,"given":"Hafize Nalan","family":"G\u00fcne\u015f","sequence":"first","affiliation":[{"name":"Department of Neurology, Ankara Training and Research Hospital, University of Health Sciences, Ankara 06018, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7365-5070","authenticated-orcid":false,"given":"Burcu G\u00f6k\u00e7e","family":"\u00c7okal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ankara Training and Research Hospital, University of Health Sciences, Ankara 06018, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melih","family":"Alt\u0131karde\u015f","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ankara Training and Research Hospital, University of Health Sciences, Ankara 06018, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6zde","family":"Orman","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Neuro-Ophthalmology, Ankara Training and Research Hospital, University of Health Sciences, Ankara 06018, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevim","family":"Kuyumcu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ac\u0131badem Kozyata\u011f\u0131 Hospital, Istanbul 34734, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcrsel","family":"G\u00fcne\u015f","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Hematology, Ankara Etlik City Hospital, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levent Ertu\u011frul","family":"\u0130nan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ankara Training and Research Hospital, University of Health Sciences, Ankara 06018, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1136\/jnnp-2017-317440","article-title":"Idiopathic intracranial hypertension: Consensus guidelines on management","volume":"89","author":"Mollan","year":"2018","journal-title":"J. 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