{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:17:33Z","timestamp":1791811053744,"version":"4.3.4"},"reference-count":56,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Idiopathic intracranial hypertension (IIH) during pregnancy presents significant challenges due to the physiological gestational changes, which can exacerbate its symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic review on studies reporting maternal\u2010fetal outcomes of IIH during pregnancy, selecting 49 papers reporting on clinical course, management strategies, and mode of delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We retrieved 165 patients with 178 pregnancies affected by IIH. Obesity represented a common risk factor (69.1%), but the association with other cardiovascular and metabolic risk factors was poorly discussed. Overall, 62.9% presented worsening of the headache and 66.8% impairing visual disturbances, but these data were extrapolated from single cases or small series comporting a selection bias potentially overestimating the real risk.<\/jats:p><jats:p>First\u2010line treatment is currently represented by acetazolamide (52 cases) or other diuretics (4 cases) associated with weight control. Serial lumbar punctures (LP) were reported in 26.9% of cases of ineffective pharmacological treatment. Shunt (3.9%) and optic nerve sheath fenestration (1.1%) were overall performed in a minority of cases.<\/jats:p><jats:p>Second\u2010line management was characterized by serial LP in patients initially treated only with diuretics and shunt placement (4.5%) or optic nerve sheath fenestration (1.7%) for patients requiring continuous CSF subtractions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although pregnancy\u2010related physiological changes may exacerbate the IIH and the actual risk remains difficult to quantify, this appears overall low in terms of re\u2010exacerbation of the disease or de\u2010novo onset. Diuretics, in particular acetazolamide, that did not show a causal relationship with congenital malformations, and serial lumbar punctures represent safe and effective first\u2010line managements, whereas shunt procedures should be reserved for fulminant cases. A pre\u2010gestational symptoms relief seems to reduce the probability of a severe worsening in pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.70186","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T12:44:56Z","timestamp":1747745096000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Idiopathic Intracranial Hypertension in Pregnancy. A Systematic Review on Clinical Course, Treatments, Delivery and Maternal\u2010Fetal Outcome"],"prefix":"10.1111","volume":"32","author":[{"given":"Matteo","family":"Palermo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Fondazione Policlinico Universitario A. 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