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. of the cerebrospinal fluidFluid that is made by specialized cells in the ventricles of the brain. (shunting), optic nerve sheath fenestrationA surgical procedure performed that allows cerebrospinal fluid to pass around the optic nerve freely (ONSF) and venous sinus stentingA minimally invasive surgery during which a metallic mesh in the shape of a tube (stent) is placed in the sinus. (VSSA minimally invasive surgery during which a metallic mesh in the shape of a tube (stent) is placed in the sinus.). 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. 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., 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.