Stenting versus shunting in sight-threatening idiopathic intracranial hypertension: genuine equipoise.
Abstract
This opinion piece discusses the challenges of managing a person with sight-threatening papilloedema due to idiopathic intracranial hypertension (IIH). With no available randomised controlled trials, clinicians often choose locally available surgical intervention. An increasing number of studies have advocated using dural venous sinus stenting in IIH. Big data studies show that shunts have been the mainstay of surgical treatment for IIH, and recent evidence shows improved outcomes and fewer revision surgeries. There remains genuine equipoise in the choice of intervention between shunting and dural venous stenting in IIH. The IIH Intervention Trial funded by the National Institute of Health Research is underway in the UK, the first randomised control trial to evaluate both of these surgical interventions in people with sight-threatening IIH.
Date
2025-12-09
Type
Article
Subject
Cerebrospinal fluid, Cerebrospinal fluid shunts, Ophthamology, Radiology, Neurosurgery
Collections
Citation
Mollan SP, Tsermoulas G, Berman G, Toma AK, Fergus R, White P, Wakerley BR, Sinclair AJ. Stenting versus shunting in sight-threatening idiopathic intracranial hypertension: genuine equipoise. Pract Neurol. 2026 Mar 13;26(2):142-145. doi: 10.1136/pn-2025-004728.
Journal / Source Title
Practical Neurology
DOI
10.1136/pn-2025-004728
PMID
41381103
Publisher
BMJ Pub. Group
Publisher’s URL
https://pn.bmj.com/content/by/year