Bariatric Surgery in Patients With Idiopathic Intracranial Hypertension—The Silver Bullet?

Abstract

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Reader Response: Association of Amount of Weight Lost After Bariatric Surgery With Intracranial Pressure in Women With Idiopathic Intracranial Hypertension

“…However, surgery did not have a greater effect on papilledema grade, visual function, or headache disability than CWM. 3 More specifically, there was no difference in visual acuity, contrast sensitivity, perimetric mean deviation, or optic nerve and the retinal nerve fiber layer. Given that loss of vision is the most severe complication in IIH, and headache is the principal symptom, not highlighting these supplementary data in either the initial or follow-up paper seems to be a crucial omission.…”

Progress and recognition of idiopathic intracranial hypertension: A narrative review

“…Persistent weight loss is a key strategy for mitigating the symptoms of intracranial hypertension and reducing the risk of complications associated with obesity. 140 , 141 , 142 Although the 2018 consensus guidelines on the management of IIH suggested that all patients with a BMI >30 kg/m 2 should prioritize weight management, they did not specify the amount of weight loss necessary to improve the disease or the most effective weight loss strategy. 6 The IIH:WT, involving 66 females with active IIH and a BMI of ≥35 kg/m 2 at five UK hospitals, showed that bariatric surgery was significantly more effective in reducing ICP than were community weight management programs.…”

Literature Commentary

“…Some limitations are pointed out by Deb Friedman in an accompanying editorial(1). For instance, 14 (42.4%) participants randomized to the weight management arm never attended a Weight Watchers session, 2 participants withdrew from the study, and 2 participants underwent bariatric surgery on their own.…”