Glucagon-Like Peptide-1 Analogue In The Management Of Rebound Intracranial Hypertension: A Case Report
Bibliographic record
Abstract
Background: Rebound intracranial hypertension (RIH) is a possible complication of epidural blood patching used in the management of spontaneous intracranial hypotension (SIH). RIH has been reported to occur in up to 27% of patients after SIH treatment and is characterized by elevated intracranial pressure, resulting in severe headache, nausea, and vomiting. Although it typically resolves spontaneously, treatment may be warranted for symptom control. While acetazolamide is the most commonly used agent for RIH, there are side-effects, and its efficacy remains inconclusive. Recently, novel glucagon-like peptide-1 (GLP-1) analogues have been found to modulate CSF secretion and consequently reduce intracranial pressure. However, there are no studies that have evaluated the use of these agents in the treatment of RIH. We report of a case of a 46 year old female patient with persistent RIH after CSF leak repair that was refractory to pharmacologic and interventional treatments. The patient was treated with Semaglutide, an oral GLP-1 analogue and experienced immediate and sustained benefit of her symptoms. Conclusion: RIH is a common complication after successful patching of a CSF leak, a proportion of patients suffer from persistent and debilitating headaches. Our case report showed that GLP-1 agonist Semaglutide appeared to reduce symptoms in this one patient with refractory RIH symptoms. The use of GLP-1 agonists in the treatment of RIH should be evaluated in controlled studies to establish its safety and efficacy in this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.007 | 0.005 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".