Surgical Treatment for Idiopathic Intracranial Hypertension: Optic Nerve Sheath Fenestration

Venous sinus stenosis has been observed in patients with idiopathic intracranial hypertension (IIH) over the last two decades. Uncertainty remains as to whether this stenosis is the result or cause of intracranial hypertension in certain patients with the disease or whether it may be both. The association of venous sinus stenosis with IIH has led to multiple case reports and retrospective studies detailing the outcomes of patients following venous sinus stenting. The rate of serious irreversible complications appears to be relatively small, but more studies with long-term follow up are needed to fully evaluate its safety. Rates of post-procedure improvement in symptoms, papilledema and visual field defects are promising, but a controlled, prospective trial is needed to properly evaluate its efficacy in stabilizing or reversing symptoms and visual loss in patients with IIH.