Summary
A systematic review is the questioning of the large databases of the medical literature to analyze all the published articles on a specific subject.
This review compares the results of the three main surgeries to treat IIH patients who have failed medical therapy. The three main procedures to treat IIH are: shuntingA surgery during which a hollow tube (shunt) is placed in the sinus to help drain cerebrospinal fluid. Click the term to read more of the cerebrospinal fluidFluid that is made by specialized cells in the ventricles of the brain. Click the term to read more (shunting), optic nerve sheath fenestrationA surgical procedure performed that allows cerebrospinal fluid to pass around the optic nerve freely Click the term to read more (ONSFoptic nerve sheath fenestration Click the term to read more) and venous sinus stentingA minimally invasive surgery during which a metallic mesh in the shape of a tube (stent) is placed in the sinus. Click the term to read more (VSSA minimally invasive surgery during which a metallic mesh in the shape of a tube (stent) is placed in the sinus. Click the term to read more). Additionally, the study also included a few cases of morbidly obese patients who underwent bariatric surgeryAn invasive procedure where the stomach is surgically manipulated to assist with weight loss. It is also known as weight-loss surgery. Click the term to read more to lose weight. This review included 2302 patients.
The authors analyzed the results of these surgeries on various symptoms and examination findings of IIH such as papilledemaSwelling of the optic nerve that carries visual signals from the eye to the brain. Click the term to read more, visual field deterioration, and headaches. They also analyzed the rate of severe complications and the rate of recurrence (deterioration after initial improvement). The results are summarized in the table below.