Efficacy, complications and cost of surgical interventions for idiopathic intracranial hypertension: a systematic review of the literature

Abstract

No surgical modality proved to be clearly superior to any other in IIH management. However, in certain contexts, a given approach appears more justified. Therefore, a treatment algorithm has been formulated, based on the extracted evidence of this review. The traditional treatment paradigm may need to be re-examined with sinus stenting as a first-line treatment modality.

Validation of Davson’s equation in patients suffering from idiopathic normal pressure hydrocephalus

“…Alarmingly, the correlation between Rout and ICPbeg demonstrated an even stronger age dependency in the group of patients with a final clinical diagnosis of NPH. This is an interesting finding that could be used to argue in favour of the importance of age-adjustment for Rout calculations in hydrocephalic individuals, to assist NPH diagnosis and shunt prognostication [17][18][19]23]. Finally, the similar behaviour of the correlation in the group of patients who positively responded to shunting, that is the strongly age-dependent detection of the correlation, absent in the non-responders, could also have additional value to the new chapter of Rout optimisation and CSF dynamics studies in hydrocephalic patients.…”

Management of Idiopathic Intracranial Hypertension: Experience of a North African Center

“…1,4,12,13 The main neuroimaging findings that may accompany IIH are empty sella (70%), distension (45%), and tortuosity (40%) of the perioptic subarachnoid space, flattening of the posterior sclera (80%), and protrusion of optic nerve papillae into the vitreous and transverse sinus stenosis (90%). 5,14,15 IIH corresponds an increased ICP of unknown cause (thereby excluding secondary intracranial hypertension). 4,7 In IIH, the CSF composition is normal.…”

“…4,7 In IIH, the CSF composition is normal. [1][2][3]5,7,9,10,[12][13][14][15][16][17][18][19][20][21] The pseudotumor name cerebri seems incorrectly understood, since it includes secondary causes of intracranial hypertension with the exception of lesions occupying space. 3,4 It is more logical to call them pseudotumor cerebri primitive.…”

“…► No other etiology of ICH. 1,13,15,21 The advance of imaging has significantly modified the evaluation of patients with possible IIH. 13 The main goal of the treatment was to reduce ICP in order to avoid blindness by papillary edema in emergency.…”

“…IIH does not currently have a well-established management algorithm, given the paucity of studies on the issue. 1,3,8,17,19 Kalyvas et al 15 in a systemic review of literature declare that treatment options range from conservative to interventional and surgical.…”