Prompt diagnosis and multidisciplinary management of IIH promote favorable clinical and neuro-ophthalomologic outcome, avoiding invasive treatments.

Objectives: Idiopathic Intracranial Hypertension (IIH) is characterized by increased intracranial pressure without an identifiable cause. It typically presents with symptoms such as severe headache, visual disturbances, and papilledema. Its incidence is approximately 1–3 cases per 100,000 people annually, primarily affecting young, obese women. Headache, reported in 84% of patients, varies in nature (migraine-like, tension-type) and is frequently misdiagnosed. Visual symptoms, including transient visual obscurations (68%) and diplopia (18%), are also common. This condition can lead to significant morbidity, especially visual loss and disabling headache. Management options include weight reduction, diuretics, and, in refractory cases, surgical interventions such as ventriculoperitoneal shunting, optic nerve sheath fenestration, or, more recently, venous sinus stenting. Given the variable prognosis, this study aimed to evaluate the effectiveness of a prompt, multidisciplinary approach involving neurologists and neuro-ophthalmologists in achieving favorable clinical outcomes. Materials and Methods: We conducted a retro-prospective analysis of patients diagnosed with IIH at our hospital between January 2020 and May 2025. The timing of patient assessments and the collaboration between neurologists and neuro-ophthalmologists were documented. The effectiveness of early, multidisciplinary, conservative interventions was evaluated in terms of clinical outcomes and the need for invasive treatments. Timely, patient-tailored interventions included pharmacological therapy, weight management, lifestyle modifications (e.g., smoking cessation), and invasive procedures when necessary. Results: Twenty-eight patients (22 females, mean age 36± 14 years, mean BMI 31 ± 7) were included. In 86% of cases, neurological and neuro-ophthalmological evalutions occurred within one month of symptom onset. Disabling headache was reported by 90%, papilledema by 96%, and visual disturbances by 96% of patients. Acetazolamidewas administered to 96% of patients, 63% achieved weight loss, and 73% either reduced or quit smoking (among 11 smokers). Invasive treatments were required in only two patients—one with a dural arteriovenous fistula and another with focal transverse sinus stenosis. Overall, 93% of patients showed rapid improvement in both headache and papilledema, as assessed by fundus photography and spectral-domain optical coherence tomography (OCT). Discussion: Early multidisciplinary intervention led to favorable outcomes, including reduced progression of papilledema and resolution of symptoms, thus minimizing the need for invasive procedures. Conclusion: Timely diagnosis and collaboration between neurologists and neuro-ophthalmologists are crucial for preventing disease progression and optimizing the management of IIH, enhancing the overall quality of life.