{"title":"Does optic nerve sheath fenestration alleviate headaches in patients with idiopathic intracranial hypertension? A retrospective study","authors":"Hüseyin Nezih Özdemir , Neşe Çelebisoy , Figen Gökçay , Anıl Yakut , Meltem Söylev Bajin , Aylin Yaman","doi":"10.1016/j.jocn.2025.111447","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate headache course after optic nerve sheath fenestration (ONSF) in idiopathic intracranial hypertension (IIH) patients.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, IIH patients’ data who had undergone ONSF due to progressive visual field loss despite medical treatment or advanced visual field loss at onset, including age, sex, cerebrospinal fluid (CSF) opening pressure, laterality of ONSF (unilateral or bilateral), best corrected visual acuity (BCVA), visual field mean deviation (MD) preoperatively and after ONSF in the worse and fellow eyes, were noted. Headache severity assessed using the visual analog scale, and headache frequency defined as the number of headache days per month before and after surgery were considered.</div></div><div><h3>Results</h3><div>20 patients (17 females, 3 males) with a mean age of 32.4 years and a mean CSF opening pressure of 492.79 mm H2O were studied. ONSF was unilateral in 12 (60 %) and bilateral in 8 (40 %) patients. Median LogMAR BCVA and MD in the worse eye improved significantly after surgery (p = 0.04 and p = 0.02, respectively), whereas improvement in the fellow eye was not significant (p > 0.05). Though headache severity and frequency decreased after surgery (p = 0.01 and p = 0.001, respectively) it was still present in 12 patients (60 %). Age, sex, CSF opening pressure, uni/bilateral ONSF, BCVA or MD in the worse or fellow eye had no effect on the course of headache severity or frequency.</div></div><div><h3>Conclusion</h3><div>Specific headache treatment is essential in IIH, since lowering intracranial pressure by ONSF is not associated with headache relief in over half of the patients.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"139 ","pages":"Article 111447"},"PeriodicalIF":1.8000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0967586825004205","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
To evaluate headache course after optic nerve sheath fenestration (ONSF) in idiopathic intracranial hypertension (IIH) patients.
Methods
In this retrospective cohort study, IIH patients’ data who had undergone ONSF due to progressive visual field loss despite medical treatment or advanced visual field loss at onset, including age, sex, cerebrospinal fluid (CSF) opening pressure, laterality of ONSF (unilateral or bilateral), best corrected visual acuity (BCVA), visual field mean deviation (MD) preoperatively and after ONSF in the worse and fellow eyes, were noted. Headache severity assessed using the visual analog scale, and headache frequency defined as the number of headache days per month before and after surgery were considered.
Results
20 patients (17 females, 3 males) with a mean age of 32.4 years and a mean CSF opening pressure of 492.79 mm H2O were studied. ONSF was unilateral in 12 (60 %) and bilateral in 8 (40 %) patients. Median LogMAR BCVA and MD in the worse eye improved significantly after surgery (p = 0.04 and p = 0.02, respectively), whereas improvement in the fellow eye was not significant (p > 0.05). Though headache severity and frequency decreased after surgery (p = 0.01 and p = 0.001, respectively) it was still present in 12 patients (60 %). Age, sex, CSF opening pressure, uni/bilateral ONSF, BCVA or MD in the worse or fellow eye had no effect on the course of headache severity or frequency.
Conclusion
Specific headache treatment is essential in IIH, since lowering intracranial pressure by ONSF is not associated with headache relief in over half of the patients.
期刊介绍:
This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology.
The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.