Interventions for idiopathic intracranial hypertension

Lueck, Christian J.; McIlwaine, Gawn G.

doi:10.1002/14651858.cd003434.pub2

Cited by 59 publications

(40 citation statements)

References 29 publications

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“…The selection of CSF diversion surgical technique remains strongly influenced by available local expertise, and multicentre prospective controlled studies are urgently needed. [22][23][24] ONSD for other disorders After a period of enthusiasm, the role of ONSD for the progressive form of nonarteritic ischaemic optic neuropathy has passed out of favour. The concept that decompressing the retrolaminar optic nerve fibres would ameliorate a disease process acting at the level of the lamina cribrosa was not supported by the Ischemic Optic Neuropathy Decompression Trial in 1995.…”

Section: Csf Diversion Surgery By Shuntingmentioning

confidence: 99%

Optic nerve disorders: role of canal and nerve sheath decompression surgery

Acheson

2004

Eye

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Optic nerve sheath decompression (ONSD) maintains a role in the management of visual loss complicating papilloedema in selected patients primarily with idiopathic intracranial hypertension. The evidence base for this intervention is reviewed and audit data on visual outcomes for patients with acute, chronic, and atrophic forms of papilloedema are contrasted. Optic canal decompression has a role in the management of compressive optic neuropathies complicating mass lesions arising from paranasal sinuses and intracranially and can be achieved by transethmoidal, transbasal, and open craniotomy routes. The evidence base supporting this intervention in traumatic optic neuropathy and in primary bone disease causing canal stenosis (in particular fibrous dysplasia) is reviewed where the indications are more controversial.

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Section: Csf Diversion Surgery By Shuntingmentioning

confidence: 99%

Optic nerve disorders: role of canal and nerve sheath decompression surgery

Acheson

2004

Eye

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“…There are no evidence-based guidelines in the management of IIH, and randomized studies supporting treatment efficacy are lacking. 10 The pathophysiology of raised intracranial pressure in IIH remains unclear. [1][2][3][4] Various mechanisms have been proposed, including excess CSF production, impaired CSF absorption, or increased cerebral venous pressure.…”

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confidence: 99%

Unilateral Transverse Sinus Stenting of Patients with Idiopathic Intracranial Hypertension

Bussiére¹,

Falero²,

Nicolle³

et al. 2009

AJNR Am J Neuroradiol

154

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“…Unfortunately, there are no evidence-based studies in which the risks and benefits of various interventions are assessed. 28 Furthermore, the relative rarity of severe complications of IIH and the variability in presentation make prospective clinical trials very problematic. Thus, in the absence of a scientifically demonstrated advantage for any single treatment, the indications for a particular therapy differ widely depending upon the biases of the treating physicians.…”

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confidence: 99%

Visual outcomes comparing surgical techniques for management of severe idiopathic intracranial hypertension

Feldon¹

2007

Neurosurgical FOCUS

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Object. The object of this study was to compare surgical techniques for management of visual loss in idiopathic intracranial hypertension (IIH) unresponsive to medical treatment.Methods. The published literature was reviewed using electronic and manual search techniques. Articles were categorized based upon the surgical procedure performed, including optic nerve sheath decompression (ONSD), also called optic nerve sheath fenestration; intracranial venous sinus stent placement; ventriculoperitoneal (VP) shunt placement; and lumboperitoneal (LP) shunt placement. Demographic data and visual outcome of the cumulative experience were compiled and compared for each type of surgical intervention.Results. Seventeen patients treated by stent placement, 31 by VP shunt placement, 44 by LP shunt placement, and 252 patients by ONSD were identified in the literature; average follow-up ranged from 11.8 months for patients treated with stents to 57.2 months for those treated with LP shunts. Improved or resolved vision deficit was noted in 38.7% of patients after VP shunt placement, 47% of patients after stent placement, 44.6% of patients after LP shunt placement, and 80% of eyes after ONSD. Visual worsening was rare for all procedures evaluated.Conclusions. There is a paucity of information regarding visual outcomes from intracranial venous stent placement and cerebrospinal fluid diversion procedures. Visual outcomes from ONSD are better documented and appear to be superior to other surgical techniques for management of IIH. Further studies with improved data collection regarding visual outcomes are needed for surgical procedures other than ONSD in order to assess their possible value as treatments for visual loss in IIH.

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Interventions for idiopathic intracranial hypertension

Cited by 59 publications

References 29 publications

Optic nerve disorders: role of canal and nerve sheath decompression surgery

Optic nerve disorders: role of canal and nerve sheath decompression surgery

Unilateral Transverse Sinus Stenting of Patients with Idiopathic Intracranial Hypertension

Visual outcomes comparing surgical techniques for management of severe idiopathic intracranial hypertension

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