New horizons for idiopathic intracranial hypertension: advances and challenges.

Abstract

Idiopathic intracranial hypertension (IIH) is becoming a recognized condition due to the increasing incidence linked to a global obesity epidemic. All English papers on PubMed, Cochrane and Scholar between inception until 1 March 2020 were considered. Studies suggest central adiposity has a pathogenic role. Recent weight gain is a risk factor and weight loss has a key role in management. Interpretation of abnormal lumbar puncture opening pressure is debated. There is an increasing recognition of obesity stigma and how this should be approached. Further evidence is required for the choice of surgical intervention for fulminant IIH. Education regarding IIH should be evidence based. Novel research of the pathology of IIH is influencing development of therapies such as glucagon-like peptide-1 receptor agonists and targeting unique androgen signatures. The newly discovered cardiovascular risk requires further attention.