Efficacy and Safety of Bariatric Surgery Versus Non-surgery in the Treatment of Idiopathic Intracranial Hypertension: a Systematic Review and Meta-analysis

Abstract

Abstract Background Idiopathic intracranial hypertension (IIH) is a debilitating disorder characterized by elevated intracranial pressure (ICP). Women, reproductive age, and obesity, especially weight gain in a short period, are major risk factors in the development of IIH. Weight loss has been widely recognized as a beneficial strategy of treatment. Methods Two researchers independently and systematically searched the National Library of Medicine (PubMed/MEDLINE), the Cochrane Library, EMBASE databases, and ClinicalTrials.gov to identify articles that met the eligibility criterion. The primary outcomes are ICP and IIH-related symptoms (number of patients with headache and visual defect), and secondary outcomes are weight, body mass index (BMI), ophthalmological examination, complications and mortality at the final follow-up. Results Eventually, 1 RCT, 6 retrospective studies and 17 case reports were included in the meta-analysis. The number of patients with headaches (P = 0.01) after surgery was significantly lower than that in the nonsurgery group. ICP (P = 0.005) was reduced significantly in the bariatric surgery group. Weight (P = 0.004) and BMI (P < 0.00001) were significantly lower in the bariatric surgery group. However, there was no significant difference in visual symptoms between the two groups. Overall, the probability of complications is not high. Conclusions Our research indicated that bariatric surgery is an effective and safe treatment for patients with IIH. Bariatric surgery can effectively reduce ICP and relieve headache, which is the major distress of patients.