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New horizons for idiopathic intracranial hypertension: advances and challenges
Susan P Mollan1, Olivia Grech2,3, Zerin Alimajstorovic2,3
1Birmingham Neuro-Ophthalmology, Queen Elizabeth Hospital, Birmingham, UK.
Introduction:
Idiopathic intracranial hypertension (IIH) is becoming a recognized condition due to the increasing incidence linked to a global obesity epidemic.
Sources Of Data:
All English papers on PubMed, Cochrane and Scholar between inception until 1 March 2020 were considered.
Areas Of Agreement:
Studies suggest central adiposity has a pathogenic role. Recent weight gain is a risk factor and weight loss has a key role in management.
Areas Of Controversy:
Interpretation of abnormal lumbar puncture opening pressure is debated. There is an increasing recognition of obesity stigma and how this should be approached.
Growing Points:
Further evidence is required for the choice of surgical intervention for fulminant IIH. Education regarding IIH should be evidence based.
Areas Timely For Developing Research:
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.
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