Idiopathic intracranial hypertension treatment

Idiopathic intracranial hypertension (IIH) is still a grey area in the knowledge of the aetiology, diagnosis and management of neurosurgical diseases.

Most children respond to typical medical treatment such as intravenous carbonic anhydrase or steroids. Indication for surgical treatment include initial severe visual dysfunction or a worsening of the results of a visual test 1).

At the moment, because the etiology of IIH in children remains unclear, a specific treatment has not yet developed 2)

Until now there is no Level of Evidence 1 guideline to which our decision-making can be based on for the management of IIH. A lack of systematic reviews and randomized controlled trials has been noted 3).

Treatment typically consists of weight loss (including bariatric surgery in morbidly obese patients if needed) 4).


1)
Babikian P, Corbett J, Bell W. Idiopathic intracranial hypertension in children: the Iowa experience. J Child Neurol. 1994;9:144–149.
2)
Ko MW, Liu GT. Pediatric idiopathic intracranial hypertension (pseudotumor cerebri) Horm Res Paediatr. 2010;74:381–389
3)
Portelli M, Papageorgiou PN. An update on idiopathic intracranial hypertension. Acta Neurochir (Wien). 2016 Dec 24. doi: 10.1007/s00701-016-3050-7. [Epub ahead of print] PubMed PMID: 28013373.
4)
Fridley J, Foroozan R, Sherman V, Brandt ML, Yoshor D. Bariatric surgery for the treatment of idiopathic intracranial hypertension. J Neurosurg. 2011 Jan;114(1):34-9. doi: 10.3171/2009.12.JNS09953. Review. PubMed PMID: 20095788.
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