Journal article
Counterpoint: stenting for idiopathic intracranial hypertension should be trialed
Journal of neurointerventional surgery, Vol.15(11), pp.1063-1064
11/2023
DOI: 10.1136/jnis-2023-020404
PMID: 37344173
Abstract
[...]it must be recognized we are not treating the cause of the intracranial pressure increase: the underlying pathologic reason remains present and likely accounts for many of the treatment failures or recurrences.5 Owing to all these factors, this is a procedure that must be subjected to a randomized clinical trial against best medical therapy. Weight loss, with as little as a 6% weight reduction, is an effective treatment.6 Bariatric surgery is superior to a dietary weight loss intervention for both weight loss and a sustained reduction in intracranial pressure.7 Acetazolamide and diet is also an effective treatment.8 The Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) demonstrated that acetazolamide combined with a low-sodium weight-reduction diet was superior to diet alone for improvement in vision in patients with IIH and mild visual loss.8 Mild vision loss was defined as perimetric mean deviation (PMD), a measure of global visual field loss relative to normal age-corrected values, between −2 dB and −7 dB. The active treatment group had more improvement in PMD, papilledema and vision-related quality of life. In summary, objective data from a well-executed randomized trial showing a benefit of stenting for recovery or preservation of vision in a well-defined patient cohort would be of great value, particularly one that accurately documents complications and has visual field testing as a major outcome measure.
Details
- Title: Subtitle
- Counterpoint: stenting for idiopathic intracranial hypertension should be trialed
- Creators
- Colin Derdeyn - University of Iowa Hospitals and ClinicsMichael Wall - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.15(11), pp.1063-1064
- Publisher
- BMJ Publishing Group LTD
- DOI
- 10.1136/jnis-2023-020404
- PMID
- 37344173
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Language
- English
- Electronic publication date
- 06/21/2023
- Date published
- 11/2023
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery; Ophthalmology and Visual Sciences
- Record Identifier
- 9984436281902771
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