Arielle Spitze1, Amina Malik, Andrew G Lee. 1. aDepartment of Ophthalmology, Houston Methodist Hospital, Houston, Texas bDepartment of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio cDepartments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College, Houston, Texas dDepartment of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa eDepartment of Ophthalmology, Baylor College of Medicine, Houston fDepartment of Ophthalmology, The University of Texas Medical Branch, Galveston gUT MD Anderson Cancer Center, Houston, Texas, USA.
Abstract
PURPOSE OF REVIEW: Idiopathic intracranial hypertension (IIH) is a potentially blinding disease and may require surgical management when maximal medical treatment has failed. The purpose of this review is to discuss the current literature on surgical and endovascular treatments for IIH. RECENT FINDINGS: The most commonly performed surgical treatments for IIH are cerebrospinal fluid diversion procedures (e.g. ventriculo- and lumbo-peritoneal shunts) and optic nerve sheath fenestration. Controversy still exists about which is the preferred initial surgical treatment for IIH. Emerging procedures include venous sinus stenting in cases with venous sinus stenosis, and bariatric surgery for weight loss. Cranial (suboccipital or subtemporal) decompression was a more popular surgical procedure in the past, but can still have a role in selected cases with impaired cerebrospinal flow dynamics (e.g. Chiari malformation) or after multiple failed conventional surgical procedures. SUMMARY: This review compares and contrasts the surgical management options for IIH.
PURPOSE OF REVIEW: Idiopathic intracranial hypertension (IIH) is a potentially blinding disease and may require surgical management when maximal medical treatment has failed. The purpose of this review is to discuss the current literature on surgical and endovascular treatments for IIH. RECENT FINDINGS: The most commonly performed surgical treatments for IIH are cerebrospinal fluid diversion procedures (e.g. ventriculo- and lumbo-peritoneal shunts) and optic nerve sheath fenestration. Controversy still exists about which is the preferred initial surgical treatment for IIH. Emerging procedures include venous sinus stenting in cases with venous sinus stenosis, and bariatric surgery for weight loss. Cranial (suboccipital or subtemporal) decompression was a more popular surgical procedure in the past, but can still have a role in selected cases with impaired cerebrospinal flow dynamics (e.g. Chiari malformation) or after multiple failed conventional surgical procedures. SUMMARY: This review compares and contrasts the surgical management options for IIH.
Authors: Luisam Tarrats; Gabriel Hernández; José M Busquets; Juan C Portela; Luis A Serrano; Lorena González-Sepúlveda; José R Sánchez-Pérez Journal: Int Forum Allergy Rhinol Date: 2017-04-06 Impact factor: 3.858