ArticleSurgical neurology international2015
Over-drainage and persistent shunt-dependency in patients with idiopathic intracranial hypertension treated with shunts and bariatric surgery.
Article in Surgical neurology international, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
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Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- The Effect of Metabolic and Bariatric Surgery on Patients with Idiopathic Intracranial Hypertension; A Systematic Review and Meta-analysis.Obesity surgery · 2025Pooled it
- A systematic review of surgical treatments of idiopathic intracranial hypertension (IIH).Neurosurgical review · 2021Pooled it
- Bariatric surgery-what the ophthalmologist needs to know.Eye (London, England) · 2022Review
- A Natural History of Silent Brain Syndrome over 36 Years: A case report.Orbit (Amsterdam, Netherlands) · 2021Article
- Metabolic Concepts in Idiopathic Intracranial Hypertension and Their Potential for Therapeutic Intervention.Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society · 2018Review
- Bariatric surgery as a treatment for pseudotumor cerebri: case study and narrative review of the literature.Sao Paulo medical journal = Revista paulista de medicinaReview
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIdiopathic intracranial hypertension (IIH) may lead to visual impairment. Shunt surgery is indicated for refractory IIH-related symptoms that persist despite medical treatment, or those presenting with significant visual decline. Obesity is a risk factor for IIH; a reduction in weight has been shown to improve papilledema. Bariatric surgery (BS) has been suggested for treating IIH associated with morbid obesity. In this study, we describe a high rate of over-drainage (OD) seen in patients following shunts and BS.
methodsThe study cohort includes 13 patients with IIH that underwent shunt surgery for treatment of the IIH-related symptoms. Six patients underwent BS in addition to the shunt surgery (but not concomitantly). Seven patients had only shunt surgeries with no BS. Data were collected retrospectively.
resultsBS effectively led to weight reduction (body mass index decreasing from 43 ± 4 to 28 ± 5). Patients undergoing BS had 1-6 (2.5 ± 1.9) shunt revisions for OD following BS, as opposed to 0-3 (1.4 ± 1.1) revisions prior to BS over similar time spans (statistically insignificant difference), and 0-6 (1.6 ± 2.5) revisions among the non-BS patients over a longer time span (statistically insignificant difference). Two patients in the BS group underwent shunt externalization and closure; however, they proved to be shunt-dependent.
conclusionsPatients with IIH that undergo shunt surgery and BS (not concomitantly) may suffer from OD symptoms, necessitating multiple shunt revisions, and valve upgrades. Despite BS being a valid primary treatment for some patients with IIH, among shunted patients, BS may not lead to resolution of IIH-related symptoms and patients may remain shunt-dependent.
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