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Updated: Jan 22, 2026

Translaminar Autonomous System Model for the Modulation of Intraocular and Intracranial Pressure in Human Donor Posterior Segments
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Challenges in the management of idiopathic intracranial hypertension

Katherine Belanger1, Omar Ashraf2, Jill Rau3

  • 1Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA katherine.belanger@advocatehealth.org.

Journal of Neurointerventional Surgery
|January 20, 2026
PubMed

Insights

Idiopathic intracranial hypertension (IIH) treatments offer short-term relief but often fail long-term due to recurrence. New personalized therapies are needed for durable outcomes in this complex neurological disorder.

Area of Science:

  • Neurology
  • Ophthalmology
  • Vascular Medicine

Background:

  • Idiopathic intracranial hypertension (IIH) is a prevalent neurological disorder causing significant morbidity.
  • Current treatments provide temporary symptom relief but are limited by high recurrence rates and poor long-term efficacy.
  • Weight loss is the only disease-modifying therapy, but sustained weight reduction is challenging, and not all patients are overweight.

Purpose of the Study:

  • To review current evidence on medical and surgical treatment failures in Idiopathic Intracranial Hypertension (IIH).
  • To highlight unresolved questions in IIH pathogenesis.
  • To emphasize the need for personalized therapeutic strategies and more durable treatment options.

Main Methods:

  • Systematic review of existing literature on Idiopathic Intracranial Hypertension (IIH) treatments.
  • Analysis of medical and surgical intervention outcomes.
  • Evaluation of disease pathogenesis and treatment failure mechanisms.

Main Results:

  • Current treatments for IIH, including lifestyle changes, medications (acetazolamide, topiramate, GLP-1 agonists), and surgery, show limited long-term success.
  • High rates of symptom recurrence are common, even after interventions.
  • Pharmacologic therapies have side effect limitations, and surgical approaches may not address all pathophysiological aspects.

Conclusions:

  • Idiopathic Intracranial Hypertension (IIH) treatment failures underscore the need for a deeper understanding of its complex pathophysiology.
  • Personalized therapeutic approaches are crucial for developing more effective and durable treatments.
  • Further research into IIH pathogenesis is essential for advancing patient care and improving long-term outcomes.

Keywords:
Intracranial PressureStentVein

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