Bariatric surgery as a treatment for idiopathic intracranial hypertension: a systematic review.
BACKGROUND
Idiopathic intracranial hypertension (IIH) is a chronic neurologic disease that may result in persistent and debilitating symptoms that are refractory to conventional treatments.


OBJECTIVE
The aim of this study was to systematically review the effect of bariatric weight reduction surgery as a treatment for IIH.


METHODS
A comprehensive literature search was conducted using the following databases: MEDLINE, EMBASE, PubMed, Scopus, Web of Sciences, and the Cochrane Library. No restrictions were placed on these searches, including the date of publication.


RESULTS
A total of 85 publications were identified, and after initial appraisal, 17 were included in the final review. Overall improvement in symptoms of IIH after bariatric surgery was observed in 60 of the 65 patients observed (92%). Postoperative lumbar puncture opening pressure was shown to decrease by an average of 18.9 cmH2O in the 12 patients who had this recorded.


CONCLUSIONS
Bariatric surgery for weight loss is associated with alleviation of IIH symptoms and a reduction in intracranial pressure. Furthermore, an improvement was observed in patients where conventional treatments, including neurosurgery, were ineffective. Further prospective randomized studies with control groups and a larger number of participants are lacking within the published studies to date. There is, therefore, a strong rationale for the use of bariatric surgery in individuals with IIH for the effective treatment of this condition, as well as the efficacy of weight loss for various other obesity co-morbidities.
Welsh Institute of Metabolic and Obesity Surgery, Morriston Hospital, ABMU Health Board, Swansea, United Kingdom. Electronic address: HandleyJ1@cardiff.ac.uk.
Joel D
JD
Handley
Welsh Institute of Metabolic and Obesity Surgery, Morriston Hospital, ABMU Health Board, Swansea, United Kingdom.
Bedanta P
BP
Baruah
Welsh Institute of Metabolic and Obesity Surgery, Morriston Hospital, ABMU Health Board, Swansea, United Kingdom.
David M
DM
Williams
Welsh Institute of Metabolic and Obesity Surgery, Morriston Hospital, ABMU Health Board, Swansea, United Kingdom.
Matthew
M
Horner
Welsh Institute of Metabolic and Obesity Surgery, Morriston Hospital, ABMU Health Board, Swansea, United Kingdom.
Jonathan
J
Barry
Diabetes Research Group, Institute of Life Sciences, College of Medicine, Swansea University, Swansea, United Kingdom.
Jeffrey W
JW
Stephens
D050110:Bariatric Surgery / Q000379:methods*; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011559:Pseudotumor Cerebri / Q000209:etiology / Q000601:surgery*; D015431:Weight Loss
BIH; Bariatric surgery; Benign intracranial hypertension; Gastric band; Gastric bypass; Gastric surgery; IIH; Idiopathic intracranial hypertension; Pseudotumor cerebri; Roux-en-Y; Sleeve gastrectomy; Systematic review; Weight loss surgery