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Background:

Idiopathic intracranial hypertension (IIH) has been increasing in prevalence in the past decade, following the obesity epidemic. When medical treatment fails, surgical treatment options must be considered. However, controversy remains as to which surgical procedure is the preferred surgical option–optic nerve sheath fenestration (ONSF) or cerebrospinal fluid (CSF) shunting–for the long-term treatment of this syndrome.

Purpose:

To provide a clinical update of the pros and cons of ONSF versus shunt placement for the treatment of IIH.

Design:

This was a retrospective review of the current literature in the English language indexed in PubMed.

Methods:

The authors conducted a PubMed search using the following terms: Idiopathic IIH, pseudotumor cerebri, ONSF, CSF shunts, vetriculo-peritoneal shunting, and lumbo-peritoneal shunting. The authors included pertinent and significant original articles, review …