title: Bariatric Surgery or Non-surgical Weight Loss for Idiopathic Intracranial Hypertension? A Systematic Review and Comparison of Meta-analyses.
abstract: Idiopathic intracranial hypertension (IIH) is associated with obesity and weight loss by any means is considered beneficial in this condition.
  
  
  
  This study aims to appraise bariatric surgery vs. non-surgical weight-loss (medical, behavioural and lifestyle) interventions in IIH management.
  
  
  
  A systematic review and meta-analyses of surgical and non-surgical studies.
  
  
  
  Bariatric surgery achieved 100% papilloedema resolution and a reduction in headache symptoms in 90.2%. Non-surgical methods offered improvement in papilloedema in 66.7%, visual field defects in 75.4% and headache symptoms in 23.2%. Surgical BMI decrease was 17.5 vs. 4.2 for non-surgical methods.
  
  
  
  Whilst both bariatric surgery and non-surgical weight loss offer significant beneficial effects on IIH symptomatology, future studies should address the lack of prospective and randomised trials to establish the optimal role for these interventions.
authors.affiliation: Department of Neurosurgery, Royal Preston Hospital, Preston, Lancashire, UK.
authors.forename: James H
authors.initials: JH
authors.lastname: Manfield
authors.affiliation: Department of Neurosurgery, Royal Preston Hospital, Preston, Lancashire, UK.
authors.forename: Kenny K-H
authors.initials: KK
authors.lastname: Yu
authors.affiliation: Department of Bariatric Surgery, Chelsea and Westminster Hospital, London, UK.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Efthimiou
authors.affiliation: Department of Surgery and Cancer, Imperial College London, 3rd Floor Chelsea and Westminster Hospital Campus, 369 Fulham Road, London, SW10 9NH, UK.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
authors.affiliation: Department of Surgery and Cancer, Imperial College London, 3rd Floor Chelsea and Westminster Hospital Campus, 369 Fulham Road, London, SW10 9NH, UK.
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
authors.affiliation: Department of Bariatric Surgery, Chelsea and Westminster Hospital, London, UK. h.ashrafian@imperial.ac.uk.|Department of Surgery and Cancer, Imperial College London, 3rd Floor Chelsea and Westminster Hospital Campus, 369 Fulham Road, London, SW10 9NH, UK. h.ashrafian@imperial.ac.uk.
authors.forename: Hutan
authors.initials: H
authors.lastname: Ashrafian
mesh_terms: D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D006801:Humans; D008019:Life Style; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery; D011559:Pseudotumor Cerebri / Q000209:etiology / Q000601:surgery; D015431:Weight Loss / Q000502:physiology*
keywords: Bariatric surgery; Benign intracranial hypertension; Idiopathic intracranial hypertension; Metabolic surgery; Obesity; Pseudotumor cerebri; Weight loss