The Relationship among Obesity, Intracranial Hypertension, and Cerebrospinal Fluid Leak

Idiopathic intracranial hypertension (IIH) is a disorder characterized by elevated intracranial pressure without identifiable lesion or secondary cause. Patients can often present with otolaryngologic manifestations of IIH, such as pulsatile tinnitus, aural fullness, and cerebrospinal fluid (CSF) leak....

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Audiologists and otolaryngologists should recognise obesity and elevated intracranial pressure as potential underlying contributors when evaluating patients with unexplained cerebrospinal fluid leaks; referral for weight management and neurology input may be warranted.

Identifying the obesity–intracranial hypertension–CSF leak pathway is clinically important because treating the underlying pressure, not just the leak site, is essential to preventing recurrence.

1. 01Reviews the mechanistic link between obesity, idiopathic intracranial hypertension (IIH), and cerebrospinal fluid (CSF) leak.
2. 02Elevated intracranial pressure from IIH can drive CSF leaks detectable in otolaryngology practice.
3. 03Treatment of IIH (e.g., weight loss, medications) may be required alongside surgical repair of leaks to prevent recurrence.
4. 04Published in Otolaryngologic Clinics of North America, directly relevant to ENT and audiology scope.
5. 05Rising obesity rates make this relationship increasingly clinically relevant.

PMID

42869734

DOI

10.1016/j.otc.2026.07.001.

Journal

Otolaryngologic Clinics of North America

Publication type

review

Evidence level

1a

Population

Patients with obesity, idiopathic intracranial hypertension, and/or cerebrospinal fluid leak seen in otolaryngology settings

Intervention

Review of obesity and intracranial hypertension as risk factors for CSF leak