SynthesisEuropean journal of neurology2025
Idiopathic Intracranial Hypertension in Pregnancy. A Systematic Review on Clinical Course, Treatments, Delivery and Maternal-Fetal Outcome.
Synthesis in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Article
- Idiopathic intracranial hypertension and pregnancy: outcomes in previously shunted women.Acta neurochirurgica · 2026Article
- Idiopathic CSF dynamic disturbances causing headache: a narrative review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- Atypical bilateral papilledema during the puerperium: a case report.Frontiers in medicine · 2025Article
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Authors and funding
4 authors.
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Abstract
backgroundIdiopathic intracranial hypertension (IIH) during pregnancy presents significant challenges due to the physiological gestational changes, which can exacerbate its symptoms.
methodsWe conducted a systematic review on studies reporting maternal-fetal outcomes of IIH during pregnancy, selecting 49 papers reporting on clinical course, management strategies, and mode of delivery.
resultsWe retrieved 165 patients with 178 pregnancies affected by IIH. Obesity represented a common risk factor (69.1%), but the association with other cardiovascular and metabolic risk factors was poorly discussed. Overall, 62.9% presented worsening of the headache and 66.8% impairing visual disturbances, but these data were extrapolated from single cases or small series comporting a selection bias potentially overestimating the real risk. First-line treatment is currently represented by acetazolamide (52 cases) or other diuretics (4 cases) associated with weight control. Serial lumbar punctures (LP) were reported in 26.9% of cases of ineffective pharmacological treatment. Shunt (3.9%) and optic nerve sheath fenestration (1.1%) were overall performed in a minority of cases. Second-line management was characterized by serial LP in patients initially treated only with diuretics and shunt placement (4.5%) or optic nerve sheath fenestration (1.7%) for patients requiring continuous CSF subtractions.
conclusionsAlthough pregnancy-related physiological changes may exacerbate the IIH and the actual risk remains difficult to quantify, this appears overall low in terms of re-exacerbation of the disease or de-novo onset. Diuretics, in particular acetazolamide, that did not show a causal relationship with congenital malformations, and serial lumbar punctures represent safe and effective first-line managements, whereas shunt procedures should be reserved for fulminant cases. A pre-gestational symptoms relief seems to reduce the probability of a severe worsening in pregnancy.
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