Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 2/2017

Open Access 01-02-2017 | Review Article

Bariatric Surgery or Non-surgical Weight Loss for Idiopathic Intracranial Hypertension? A Systematic Review and Comparison of Meta-analyses

Authors: James H. Manfield, Kenny K-H. Yu, Evangelos Efthimiou, Ara Darzi, Thanos Athanasiou, Hutan Ashrafian

Published in: Obesity Surgery | Issue 2/2017

Login to get access

Abstract

Background

Idiopathic intracranial hypertension (IIH) is associated with obesity and weight loss by any means is considered beneficial in this condition.

Objectives

This study aims to appraise bariatric surgery vs. non-surgical weight-loss (medical, behavioural and lifestyle) interventions in IIH management.

Methods

A systematic review and meta-analyses of surgical and non-surgical studies.

Results

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.

Conclusions

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.
Appendix
Available only for authorised users
Literature
1.
Radhakrishnan K, Ahlskog JE, Garrity JA, et al., editors. Idiopathic intracranial hypertension. Mayo Clin Proc. 1994; Elsevier.
2.
Banik R. Obesity and the role of nonsurgical and surgical weight reduction in idiopathic intracranial hypertension. Int Ophthalmol Clin. 2014;54(1):27–41.CrossRefPubMed
3.
Friedman DI, Jacobson DM. Diagnostic criteria for idiopathic intracranial hypertension. Neurology. 2002;59(10):1492–5.CrossRefPubMed
4.
Yri HM, Wegener M, Sander B, et al. Idiopathic intracranial hypertension is not benign: a long-term outcome study. J Neurol. 2011;259(5):886–94.CrossRefPubMed
5.
Andrews LE, Liu GT, Ko MW. Idiopathic intracranial hypertension and obesity. Horm Res Paediatr. 2014;81(4):217–25.PubMed
6.
Wakerley BR, Tan MH, Ting EY. Idiopathic intracranial hypertension. Cephalalgia. 2015;35(3):248–61.CrossRefPubMed
7.
Wall M. Idiopathic intracranial hypertension (pseudotumor cerebri). Curr Neurol Neurosci Rep. 2008;8(2):87–93.CrossRefPubMed
8.
Wall M. Idiopathic intracranial hypertension and the idiopathic intracranial hypertension treatment trial. J Neuroophthalmol. 2013;33(1):1–3.CrossRefPubMed
9.
Wall M, George D. Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain. 1991;114(Pt 1A):155–80.PubMed
10.
Rowe FJ, Sarkies NJ. The relationship between obesity and idiopathic intracranial hypertension. Int J Obes Relat Metab Disord. 1999;23(1):54–9.CrossRefPubMed
11.
Biousse V, Bruce BB, Newman NJ. Update on the pathophysiology and management of idiopathic intracranial hypertension. J Neurol. 2012;83(5):488–94.
12.
Fridley J, Foroozan R, Sherman V, et al. Bariatric surgery for the treatment of idiopathic intracranial hypertension: a review. J Neurosurg. 2011;114(1):34–9.CrossRefPubMed
13.
14.
Ashrafian H, Ahmed K, Rowland SP, et al. Metabolic surgery and cancer: protective effects of bariatric procedures. Cancer. 2011;117(9):1788–99.CrossRefPubMed
15.
Handley JD, Baruah BP, Williams DM, et al. Bariatric surgery as a treatment for idiopathic intracranial hypertension: a systematic review. Surg Obes Relat Dis. 2015;11(6):1396–403.CrossRefPubMed
16.
Wall M, McDermott MP, Kieburtz KD, et al. Effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the idiopathic intracranial hypertension treatment trial. JAMA. 2014;311(16):1641–51.CrossRefPubMed
17.
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.CrossRefPubMed
18.
Wells G, Shea B, O’connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2000.
19.
Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17(1):1–12.CrossRefPubMed
20.
Sugerman HJ, Felton WL, Salvant JB, et al. Effects of surgically induced weight loss on idiopathic intracranial hypertension in morbid obesity. Neurology. 1995;45(9):1655–9.CrossRefPubMed
21.
Sugerman H, DeMaria E, Felton W, et al. Increased intra-abdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri. Neurology. 1997;49(2):507–11.CrossRefPubMed
22.
Sugerman HJ, Felton 3rd WL, Sismanis A, et al. Gastric surgery for pseudotumor cerebri associated with severe obesity. Ann Surg. 1999;229(5):634–40. discussion 40-2CrossRefPubMedPubMedCentral
23.
Michaelides EM, Sismanis A, Sugerman HJ, et al. Pulsatile tinnitus in patients with morbid obesity: the effectiveness of weight reduction surgery. Otol Neurotol. 2000;21(5):682–5.
24.
Nadkarni T, Rekate HL, Wallace D. Resolution of pseudotumor cerebri after bariatric surgery for related obesity: case report. J Neurosurg. 2004;101(5):878–80.CrossRefPubMed
25.
Egan RJ, Meredith HE, Coulston JE, et al. The effects of laparoscopic adjustable gastric banding on idiopathic intracranial hypertension. Obes Surg. 2011;21(2):161–6.CrossRefPubMed
26.
Sanmugalingam N, Khan O, Bond A, et al. The impact of bariatric surgery on idiopathic intracranial hypertensive patients. Obes Surg. 2013;23:1142.
27.
Newborg B. Pseudotumor cerebri treated: by rice-reduction diet. Arch Intern Med. 1974;133(5):802–7.CrossRefPubMed
28.
Johnson LN, Krohel GB, Madsen RW, et al. The role of weight loss and acetazolamide in the treatment of idiopathic intracranial hypertension (pseudotumor cerebri). Ophthalmology. 1998;105(12):2313–7.CrossRefPubMed
29.
Kupersmith M, Gamell L, Turbin R, et al. Effects of weight loss on the course of idiopathic intracranial hypertension in women. Neurology. 1998;50(4):1094–8.CrossRefPubMed
30.
Glueck CJ, Golnik KC, Aregawi D, et al. Changes in weight, papilledema, headache, visual field, and life status in response to diet and metformin in women with idiopathic intracranial hypertension with and without concurrent polycystic ovary syndrome or hyperinsulinemia. Transl Res. 2006;148(5):215–22.CrossRefPubMed
31.
Ball AK, Howman A, Wheatley K, et al. A randomised controlled trial of treatment for idiopathic intracranial hypertension. J Neurol. 2011;258(5):874–81.CrossRefPubMed
32.
Sinclair AJ, Burdon MA, Nightingale PG, et al. Low energy diet and intracranial pressure in women with idiopathic intracranial hypertension: prospective cohort study. BMJ. 2010;341:c2701.CrossRefPubMedPubMedCentral
33.
Pollak L, Zohar E, Glovinsky Y, et al. Reevaluation of presentation and course of idiopathic intracranial hypertension—a large cohort comprehensive study. Acta Neurol Scand. 2013;127(6):406–12.CrossRefPubMed
34.
Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56.CrossRefPubMed
35.
Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:5934.CrossRef
36.
37.
Ashrafian H, Toma T, Rowland SP, et al. Bariatric surgery or non-surgical weight loss for obstructive sleep apnoea? A systematic review and comparison of meta-analyses. Obes Surg. 2014;1-12
38.
Bower G, Toma T, Harling L, et al. Bariatric surgery and non-alcoholic fatty liver disease: a systematic review of liver biochemistry and histology. Obes Surg. 2015;1-10
39.
Fraser C, Plant GT. The syndrome of pseudotumour cerebri and idiopathic intracranial hypertension. Curr Opin Neurol. 2011;24(1):12–7.CrossRefPubMed
40.
Mcgirt MJ, Woodworth G, Thomas G, et al. Cerebrospinal fluid shunt placement for pseudotumor cerebri-associated intractable headache: predictors of treatment response and an analysis of long-term outcomes. J Neurosurg. 2004;101(4):627–32.CrossRefPubMed
41.
Jusué-Torres I, Hoffberger JB, Rigamonti D. Complications of lumboperitoneal shunts for idiopathic intracranial hypertension. Cureus. 2014;6(7):e188.
42.
Abubaker K, Ali Z, Raza K, et al. Idiopathic intracranial hypertension: lumboperitoneal shunts versus ventriculoperitoneal shunts–case series and literature review. Br J Neurosurg. 2011;25(1):94–9.CrossRefPubMed
43.
Tarnaris A, Toma AK, Watkins LD, et al. Is there a difference in outcomes of patients with idiopathic intracranial hypertension with the choice of cerebrospinal fluid diversion site: a single centre experience. Clin Neurol Neurosurg. 2011;113(6):477–9.CrossRefPubMed
44.
Lampl Y, Eshel Y, Kessler A, et al. Serum leptin level in women with idiopathic intracranial hypertension. J Neurol Neurosurg Psychiatry. 2002;72(5):642–3.CrossRefPubMedPubMedCentral
45.
Dellas C, Schäfer K, Rohm I, et al. Absence of leptin resistance in platelets from morbidly obese individuals may contribute to the increased thrombosis risk in obesity. Thromb Haemost. 2008;100(6):1123–9.PubMed
46.
Konstantinides S, Schäfer K, Neels JG, et al. Inhibition of endogenous leptin protects mice from arterial and venous thrombosis. Arterioscler Thromb Vasc Biol. 2004;24(11):2196–201.CrossRefPubMed
47.
48.
Tchaikovski SN, Rosing J. Mechanisms of estrogen-induced venous thromboembolism. Thromb Res. 2010;126(1):5–11.CrossRefPubMed
Metadata
Title
Bariatric Surgery or Non-surgical Weight Loss for Idiopathic Intracranial Hypertension? A Systematic Review and Comparison of Meta-analyses
Authors
James H. Manfield
Kenny K-H. Yu
Evangelos Efthimiou
Ara Darzi
Thanos Athanasiou
Hutan Ashrafian
Publication date
01-02-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 2/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2467-7

Other articles of this Issue 2/2017

Obesity Surgery 2/2017 Go to the issue

Original Contributions

Concomitant Removal of Gastric Band and Gastric Bypass: Analysis of Outcomes and Complications from the ACS-NSQIP Database

Original Contributions

The IGF-Axis and Diabetic Retinopathy Before and After Gastric Bypass Surgery

Original Contributions

Does Weight Gain During the Operation Wait Time Have an Impact on Weight Loss After Laparoscopic Sleeve Gastrectomy?

Original Contributions

MILEPOST Multicenter Randomized Controlled Trial: 12-Month Weight Loss and Satiety Outcomes After pose SM vs. Medical Therapy

Letter to the Editor

Letter to the Editor Concerning the Publication: “Efficacy of First-Time Intragastric Balloon in Weight Loss: a Systematic Review and Meta-Analysis of Randomized Controlled Trials”

Original Contributions

A Matched Cohort Analysis of Stomach Intestinal Pylorus Saving (SIPS) Surgery Versus Biliopancreatic Diversion with Duodenal Switch with Two-Year Follow-up