{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:04:36Z","timestamp":1780131876889,"version":"3.54.0"},"reference-count":72,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Idiopathic intracranial hypertension (IIH) is a complex disorder characterized by chronically elevated intracranial pressure (ICP) resulting in headaches and the threat of vision loss. In patients with refractory symptoms despite standard treatments, invasive ICP monitoring (ICPm) may provide critical physiological insights to guide management. However, data on the clinical utility of ICPm in IIH remain limited. This study aimed to evaluate the clinical utility of ICPm in IIH patients with refractory symptoms.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors performed a retrospective analysis of the medical records of 158 adults with IIH who underwent intraparenchymal ICPm for refractory headaches from 2016 to 2023. ICP data were classified into patterns of normal, high, low, or mixed pressure. Multilevel binomial regression models were used to assess predictors of symptom improvement, adjusting for ICPm indication, final diagnosis, and intervention type. Symptom changes were evaluated at follow-up.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The cohort was predominantly female (89.9%), with a mean age of 38.9 \u00b1 10.9 years. All patients presented with chronic headaches, with 35.4% reporting positional headaches, 54.4% visual disturbances, and 24.7% auditory symptoms. Indications for ICPm included shunt dysregulation (52.5%), suspected CSF leakage (36.1%), and elevated ICP (11.4%). Prior to ICPm, 63.9% of patients had CSF shunts in place. ICPm revealed normal pressure in 55.0%, high pressure in 10.8%, low pressure in 22.2%, and mixed patterns in 12.0% of patients. Based on ICPm findings, 42.4% of patients underwent shunt-related interventions, 6.3% received medical therapy, and 34.2% were referred to relevant clinics. Symptom improvement was observed in 46.2% of patients with headaches and > 70% with visual and auditory symptoms. Multivariable analysis showed that older age (OR 0.69, 95% CI 0.48\u20131.00; p = 0.05) and non\u2013ICP-directed treatments (symptomatic management and referral, both p < 0.02) were associated with lower odds of headache improvement, while the presence of an empty sella on imaging correlated with higher odds of improvement (OR 2.82, 95% CI 1.07\u20137.46; p = 0.04). ICPm indications had comparable odds of improvement. Referrals and non\u2013ICP-modifying treatments were associated with lower odds of symptom improvement.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n ICPm is a valuable tool in managing IIH patients with refractory symptoms, providing diagnostic clarity, guiding management decisions, and potentially avoiding unnecessary interventions. These findings underscore the heterogeneity of ICP dynamics in IIH and support ICPm as an important adjunct in complex cases.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.10.focus25867","type":"journal-article","created":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T05:51:56Z","timestamp":1767246716000},"page":"E7","source":"Crossref","is-referenced-by-count":1,"title":["Utility of intracranial pressure monitoring in idiopathic intracranial hypertension patients with refractory headaches: an 8-year, single-surgeon, specialized-center retrospective study"],"prefix":"10.3171","volume":"60","author":[{"given":"S. Farzad","family":"Maroufi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pravarakhya","family":"Puppalla","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai","family":"Chandan Reddy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omkar","family":"Katkade","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Meggyesy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John N.","family":"Theodore","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan P.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruna","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G.","family":"Luciano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Br Med Bull","first-page":"118","article-title":"New horizons for idiopathic intracranial hypertension: advances and challenges","volume":"136","author":"Mollan SP","year":"2020","unstructured":"Mollan SP, Grech O, Alimajstorovic Z, Wakerley BR, Sinclair AJ. New horizons for idiopathic intracranial hypertension: advances and challenges. Br Med Bull. 2020;136(1):118\u2013126. doi:10.1093\/bmb\/ldaa034"},{"issue":"Pt 1A","key":"b2","series-title":"Brain","first-page":"155","article-title":"Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain: a journal of neurology","volume":"114","author":"Wall M","year":"1991","unstructured":"Wall M, George D. Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain: a journal of neurology. Brain. 1991;114(Pt 1A):155\u2013180."},{"issue":"4","key":"b3","series-title":"J Neurosurg","first-page":"627","article-title":"Cerebrospinal fluid shunt placement for pseudotumor cerebri-associated intractable headache: predictors of treatment response and an analysis of long-term outcomes","volume":"101","author":"McGirt MJ","year":"2004","unstructured":"McGirt MJ, Woodworth G, Thomas G, Miller N, Williams M, Rigamonti D. Cerebrospinal fluid shunt placement for pseudotumor cerebri-associated intractable headache: predictors of treatment response and an analysis of long-term outcomes. J Neurosurg. 2004;101(4):627\u2013632. doi:10.3171\/jns.2004.101.4.0627"},{"issue":"16","key":"b4","series-title":"Cephalalgia","first-page":"1627","article-title":"Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review","volume":"31","author":"Sinclair AJ","year":"2011","unstructured":"Sinclair AJ, Kuruvath S, Sen D, Nightingale PG, Burdon MA, Flint G. Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review. Cephalalgia. 2011;31(16):1627\u20131633. doi:10.1177\/0333102411423305"},{"issue":"6","key":"b5","series-title":"World Neurosurg","first-page":"1852","article-title":"The utility of computed tomography in shunted patients with idiopathic intracranial hypertension presenting to the emergency department","volume":"84","author":"Liu A","year":"2015","unstructured":"Liu A, Elder BD, Sankey EW, Goodwin CR, Jusu\u00e9-Torres I, Rigamonti D. The utility of computed tomography in shunted patients with idiopathic intracranial hypertension presenting to the emergency department. World Neurosurg. 2015;84(6):1852\u20131856. doi:10.1016\/j.wneu.2015.08.008"},{"issue":"13","key":"b6","series-title":"Neurology","first-page":"1159","article-title":"Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children","volume":"81","author":"Friedman DI","year":"2013","unstructured":"Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology. 2013;81(13):1159\u20131165. doi:10.1212\/WNL.0b013e3182a55f17"},{"issue":"1","key":"b7","series-title":"Lancet Neurol","first-page":"78","article-title":"Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions","volume":"15","author":"Markey KA","year":"2016","unstructured":"Markey KA, Mollan SP, Jensen RH, Sinclair AJ. Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions. Lancet Neurol. 2016;15(1):78\u201391. doi:10.1016\/S1474-4422(15)00298-7"},{"issue":"12","key":"b8","series-title":"Int J Mol Sci","first-page":"28979","article-title":"Advances in intracranial pressure monitoring and its significance in managing traumatic brain injury","volume":"16","author":"Kawoos U","year":"2015","unstructured":"Kawoos U, McCarron RM, Auker CR, Chavko M. Advances in intracranial pressure monitoring and its significance in managing traumatic brain injury. Int J Mol Sci. 2015;16(12):28979\u201328997. doi:10.3390\/ijms161226146"},{"issue":"10","key":"b9","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1088","article-title":"Idiopathic intracranial hypertension: consensus guidelines on management","volume":"89","author":"Mollan SP","year":"2018","unstructured":"Mollan SP, Davies B, Silver NC, Idiopathic intracranial hypertension: consensus guidelines on management. J Neurol Neurosurg Psychiatry. 2018;89(10):1088\u20131100. doi:10.1136\/jnnp-2017-317440"},{"issue":"6","key":"b10","series-title":"J Neurol Neurosurg Psychiatry","first-page":"813","article-title":"Monitoring and interpretation of intracranial pressure","volume":"75","author":"Czosnyka M","year":"2004","unstructured":"Czosnyka M, Pickard JD. Monitoring and interpretation of intracranial pressure. J Neurol Neurosurg Psychiatry. 2004;75(6):813\u2013821. doi:10.1136\/jnnp.2003.033126"},{"issue":"12","key":"b11","series-title":"J Neurointerv Surg","first-page":"1162","article-title":"Correlation between intracranial pressure and venous sinus pressures in patients undergoing cerebral venography and manometry","volume":"13","author":"Lee K","year":"2021","unstructured":"Lee K, Kittel C, Aldridge JB, Wolfe SQ, Brown P, Fargen KM. Correlation between intracranial pressure and venous sinus pressures in patients undergoing cerebral venography and manometry. J Neurointerv Surg. 2021;13(12):1162\u20131166. doi:10.1136\/neurintsurg-2020-017161"},{"issue":"2","key":"b12","series-title":"Neurosurgery","first-page":"181","article-title":"The relationship between ventricular fluid pressure and body position in normal subjects and subjects with shunts: a telemetric study","volume":"26","author":"Chapman PH","year":"1990","unstructured":"Chapman PH, Cosman ER, Arnold MA. The relationship between ventricular fluid pressure and body position in normal subjects and subjects with shunts: a telemetric study. Neurosurgery. 1990;26(2):181\u2013189. doi:10.1097\/00006123-199002000-00001"},{"issue":"suppl 1","key":"b13","series-title":"J Neurotrauma","first-page":"S55","article-title":"Guidelines for the management of severe traumatic brain injury. VIII. Intracranial pressure thresholds","volume":"24","author":"Bratton SL","year":"2007","unstructured":"Bratton SL, Chestnut RM, Ghajar J, Guidelines for the management of severe traumatic brain injury. VIII. Intracranial pressure thresholds. J Neurotrauma. 2007;24(suppl 1):S55\u2013S58."},{"issue":"1","key":"b14","series-title":"Fluids Barriers CNS","first-page":"19","article-title":"Reference values for intracranial pressure and lumbar cerebrospinal fluid pressure: a systematic review","volume":"18","author":"Norager NH","year":"2021","unstructured":"Norager NH, Olsen MH, Pedersen SH, Riedel CS, Czosnyka M, Juhler M. Reference values for intracranial pressure and lumbar cerebrospinal fluid pressure: a systematic review. Fluids Barriers CNS. 2021;18(1):19. doi:10.1186\/s12987-021-00253-4"},{"issue":"3","key":"b15","series-title":"Neurocrit Care","first-page":"880","article-title":"A comprehensive perspective on intracranial pressure monitoring and individualized management in neurocritical care: results of a survey with global experts","volume":"41","author":"Brasil S","year":"2024","unstructured":"Brasil S, Godoy DA, Videtta W, A comprehensive perspective on intracranial pressure monitoring and individualized management in neurocritical care: results of a survey with global experts. Neurocrit Care. 2024;41(3):880\u2013892."},{"issue":"1","key":"b16","series-title":"Anesth Analg","first-page":"240","article-title":"Monitoring intracranial pressure in traumatic brain injury","volume":"106","author":"Smith M","year":"2008","unstructured":"Smith M. Monitoring intracranial pressure in traumatic brain injury. Anesth Analg. 2008;106(1):240\u2013248. doi:10.1213\/01.ane.0000297296.52006.8e"},{"issue":"1","key":"b17","series-title":"Neurocrit Care","first-page":"228","article-title":"Detection and management of elevated intracranial pressure in the treatment of acute community-acquired bacterial meningitis: a systematic review","volume":"41","author":"El-Hajj VG","year":"2024","unstructured":"El-Hajj VG, Pettersson I, Gharios M, Detection and management of elevated intracranial pressure in the treatment of acute community-acquired bacterial meningitis: a systematic review. Neurocrit Care. 2024;41(1):228\u2013243. doi:10.1007\/s12028-023-01937-5"},{"issue":"8","key":"b18","series-title":"CNS Neurosci Ther","first-page":"e14895","article-title":"Progress and recognition of idiopathic intracranial hypertension: a narrative review","volume":"30","author":"Zhou C","year":"2024","unstructured":"Zhou C, Zhou Y, Liu L, Progress and recognition of idiopathic intracranial hypertension: a narrative review. CNS Neurosci Ther. 2024;30(8):e14895. doi:10.1111\/cns.14895"},{"issue":"4","key":"b19","series-title":"J Neurol Neurosurg Psychiatry","first-page":"375","article-title":"Understanding the pathophysiology of idiopathic intracranial hypertension (IIH): a review of recent developments","volume":"95","author":"Colman BD","year":"2024","unstructured":"Colman BD, Boonstra F, Nguyen MN, Understanding the pathophysiology of idiopathic intracranial hypertension (IIH): a review of recent developments. J Neurol Neurosurg Psychiatry. 2024;95(4):375\u2013383. doi:10.1136\/jnnp-2023-332222"},{"issue":"5","key":"b20","series-title":"J Neurol Neurosurg Psychiatry","first-page":"488","article-title":"Update on the pathophysiology and management of idiopathic intracranial hypertension","volume":"83","author":"Biousse V","year":"2012","unstructured":"Biousse V, Bruce BB, Newman NJ. Update on the pathophysiology and management of idiopathic intracranial hypertension. J Neurol Neurosurg Psychiatry. 2012;83(5):488\u2013494. doi:10.1136\/jnnp-2011-302029"},{"issue":"4","key":"b21","series-title":"Ther Adv Neurol Disord","first-page":"317","article-title":"The diagnosis and management of idiopathic intracranial hypertension and the associated headache","volume":"9","author":"Jensen RH","year":"2016","unstructured":"Jensen RH, Radojicic A, Yri H. The diagnosis and management of idiopathic intracranial hypertension and the associated headache. Ther Adv Neurol Disord. 2016;9(4):317\u2013326. doi:10.1177\/1756285616635987"},{"key":"b22","series-title":"J Clin Neurosci","first-page":"172","article-title":"Idiopathic intracranial hypertension: pathophysiology, diagnosis and management","volume":"95","author":"Wang MTM","year":"2022","unstructured":"Wang MTM, Bhatti MT, Danesh-Meyer HV. Idiopathic intracranial hypertension: pathophysiology, diagnosis and management. J Clin Neurosci. 2022;95:172\u2013179. doi:10.1016\/j.jocn.2021.11.029"},{"issue":"7","key":"b23","series-title":"Life (Basel)","first-page":"718","article-title":"Awareness, diagnosis and management of idiopathic intracranial hypertension","volume":"11","author":"Jensen RH","year":"2021","unstructured":"Jensen RH, Vukovic-Cvetkovic V, Korsbaek JJ, Wegener M, Hamann S, Beier D. Awareness, diagnosis and management of idiopathic intracranial hypertension. Life (Basel). 2021;11(7):718. doi:10.3390\/life11070718"},{"issue":"3","key":"b24","series-title":"J Neuroophthalmol","first-page":"202","article-title":"Short-term continuous intraparenchymal intracranial pressure monitoring in presumed idiopathic intracranial hypertension","volume":"31","author":"Warden KF","year":"2011","unstructured":"Warden KF, Alizai AM, Trobe JD, Hoff JT. Short-term continuous intraparenchymal intracranial pressure monitoring in presumed idiopathic intracranial hypertension. J Neuroophthalmol. 2011;31(3):202\u2013205. doi:10.1097\/WNO.0b013e3182183c8d"},{"issue":"1","key":"b25","series-title":"BMC Neurol","first-page":"343","article-title":"Long-term telemetric intracranial pressure monitoring for diagnosis and therapy optimisation of idiopathic intracranial hypertension","volume":"21","author":"Velazquez Sanchez VF","year":"2021","unstructured":"Velazquez Sanchez VF, Al Dayri G, Tschan CA. Long-term telemetric intracranial pressure monitoring for diagnosis and therapy optimisation of idiopathic intracranial hypertension. BMC Neurol. 2021;21(1):343. doi:10.1186\/s12883-021-02349-8"},{"issue":"6","key":"b26","series-title":"Otolaryngol Head Neck Surg","first-page":"1061","article-title":"Increased intracranial pressure in spontaneous CSF leak patients is not associated with papilledema","volume":"151","author":"Aaron G","year":"2014","unstructured":"Aaron G, Doyle J, Vaphiades MS, Riley KO, Woodworth BA. Increased intracranial pressure in spontaneous CSF leak patients is not associated with papilledema. Otolaryngol Head Neck Surg. 2014;151(6):1061\u20131066. doi:10.1177\/0194599814551122"},{"issue":"4","key":"b27","series-title":"J Neuroophthalmol","first-page":"487","article-title":"Do most patients with a spontaneous cerebrospinal fluid leak have idiopathic intracranial hypertension?","volume":"39","author":"Bidot S","year":"2019","unstructured":"Bidot S, Levy JM, Saindane AM, Oyesiku NM, Newman NJ, Biousse V. Do most patients with a spontaneous cerebrospinal fluid leak have idiopathic intracranial hypertension? J Neuroophthalmol. 2019;39(4):487\u2013495. doi:10.1097\/WNO.0000000000000761"},{"issue":"4","key":"b28","series-title":"J Neuroophthalmol","first-page":"330","article-title":"Primary spontaneous cerebrospinal fluid leaks and idiopathic intracranial hypertension","volume":"33","author":"P\u00e9rez MA","year":"2013","unstructured":"P\u00e9rez MA, Bialer OY, Bruce BB, Newman NJ, Biousse V. Primary spontaneous cerebrospinal fluid leaks and idiopathic intracranial hypertension. J Neuroophthalmol. 2013;33(4):330\u2013337. doi:10.1097\/WNO.0b013e318299c292"},{"issue":"1","key":"b29","series-title":"J Headache Pain","first-page":"27","article-title":"Intracranial pressure monitoring in patients with spontaneous onset of orthostatic headache","volume":"26","author":"D\u2019Antona L","year":"2025","unstructured":"D\u2019Antona L, Cheema S, Mehta D, Intracranial pressure monitoring in patients with spontaneous onset of orthostatic headache. J Headache Pain. 2025;26(1):27. doi:10.1186\/s10194-024-01928-7"},{"issue":"9","key":"b30","series-title":"Acta Neurochir (Wien)","first-page":"1813","article-title":"The role of ICP monitoring in patients with persistent cerebrospinal fluid leak following spinal surgery: a case series","volume":"158","author":"Craven C","year":"2016","unstructured":"Craven C, Toma AK, Khan AA, Watkins LD. The role of ICP monitoring in patients with persistent cerebrospinal fluid leak following spinal surgery: a case series. Acta Neurochir (Wien). 2016;158(9):1813\u20131819. doi:10.1007\/s00701-016-2882-5"},{"issue":"1","key":"b31","series-title":"Int Forum Allergy Rhinol","first-page":"71","article-title":"Perioperative continuous cerebrospinal fluid pressure monitoring in patients with spontaneous cerebrospinal fluid leaks","volume":"5","author":"Xie YJ","year":"2015","unstructured":"Xie YJ, Shargorodsky J, Lane AP, Perioperative continuous cerebrospinal fluid pressure monitoring in patients with spontaneous cerebrospinal fluid leaks. Int Forum Allergy Rhinol. 2015;5(1):71\u201377. doi:10.1002\/alr.21424"},{"issue":"6","key":"b32","series-title":"J Neurosurg","first-page":"1503","article-title":"Hypertensive slit ventricle syndrome: pseudotumor cerebri with a malfunctioning shunt?","volume":"119","author":"Bateman GA","year":"2013","unstructured":"Bateman GA. Hypertensive slit ventricle syndrome: pseudotumor cerebri with a malfunctioning shunt? J Neurosurg. 2013;119(6):1503\u20131510. doi:10.3171\/2013.7.JNS13390"},{"issue":"5","key":"b33","series-title":"J Neurosurg","first-page":"1076","article-title":"Intracranial pressure monitoring in pediatric and adult patients with hydrocephalus and tentative shunt failure: a single-center experience over 10 years in 146 patients","volume":"122","author":"S\u00e6hle T","year":"2015","unstructured":"S\u00e6hle T, Eide PK. Intracranial pressure monitoring in pediatric and adult patients with hydrocephalus and tentative shunt failure: a single-center experience over 10 years in 146 patients. J Neurosurg. 2015;122(5):1076\u20131086. doi:10.3171\/2014.12.JNS141029"},{"issue":"4","key":"b34","series-title":"Neurosurg Focus","first-page":"E10","article-title":"Continuous intracranial pressure monitoring via the shunt reservoir to assess suspected shunt malfunction in adults with hydrocephalus","volume":"22","author":"Geocadin RG","year":"2007","unstructured":"Geocadin RG, Varelas PN, Rigamonti D, Williams MA. Continuous intracranial pressure monitoring via the shunt reservoir to assess suspected shunt malfunction in adults with hydrocephalus. Neurosurg Focus. 2007;22(4):E10. doi:10.3171\/foc.2007.22.4.12"},{"issue":"1","key":"b35","series-title":"Curr Opin Neurol","first-page":"92","article-title":"Advances in the understanding of headache in idiopathic intracranial hypertension","volume":"32","author":"Mollan SP","year":"2019","unstructured":"Mollan SP, Hoffmann J, Sinclair AJ. Advances in the understanding of headache in idiopathic intracranial hypertension. Curr Opin Neurol. 2019;32(1):92\u201398. doi:10.1097\/WCO.0000000000000651"},{"key":"b36","series-title":"World Neurosurg","first-page":"167","article-title":"Use of intracranial pressure monitoring frequently refutes diagnosis of idiopathic intracranial hypertension","volume":"104","author":"Xu DS","year":"2017","unstructured":"Xu DS, Hlubek RJ, Mulholland CB, Knievel KL, Smith KA, Nakaji P. Use of intracranial pressure monitoring frequently refutes diagnosis of idiopathic intracranial hypertension. World Neurosurg. 2017;104:167\u2013170. doi:10.1016\/j.wneu.2017.04.080"},{"issue":"1","key":"b1","series-title":"Br Med Bull","first-page":"118","article-title":"New horizons for idiopathic intracranial hypertension: advances and challenges","volume":"136","author":"Mollan SP","year":"2020","unstructured":"Mollan SP, Grech O, Alimajstorovic Z, Wakerley BR, Sinclair AJ. New horizons for idiopathic intracranial hypertension: advances and challenges. Br Med Bull. 2020;136(1):118\u2013126. doi:10.1093\/bmb\/ldaa034"},{"issue":"Pt 1A","key":"b2","series-title":"Brain","first-page":"155","article-title":"Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain: a journal of neurology","volume":"114","author":"Wall M","year":"1991","unstructured":"Wall M, George D. Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain: a journal of neurology. Brain. 1991;114(Pt 1A):155\u2013180."},{"issue":"4","key":"b3","series-title":"J Neurosurg","first-page":"627","article-title":"Cerebrospinal fluid shunt placement for pseudotumor cerebri-associated intractable headache: predictors of treatment response and an analysis of long-term outcomes","volume":"101","author":"McGirt MJ","year":"2004","unstructured":"McGirt MJ, Woodworth G, Thomas G, Miller N, Williams M, Rigamonti D. Cerebrospinal fluid shunt placement for pseudotumor cerebri-associated intractable headache: predictors of treatment response and an analysis of long-term outcomes. J Neurosurg. 2004;101(4):627\u2013632. doi:10.3171\/jns.2004.101.4.0627"},{"issue":"16","key":"b4","series-title":"Cephalalgia","first-page":"1627","article-title":"Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review","volume":"31","author":"Sinclair AJ","year":"2011","unstructured":"Sinclair AJ, Kuruvath S, Sen D, Nightingale PG, Burdon MA, Flint G. Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review. Cephalalgia. 2011;31(16):1627\u20131633. doi:10.1177\/0333102411423305"},{"issue":"6","key":"b5","series-title":"World Neurosurg","first-page":"1852","article-title":"The utility of computed tomography in shunted patients with idiopathic intracranial hypertension presenting to the emergency department","volume":"84","author":"Liu A","year":"2015","unstructured":"Liu A, Elder BD, Sankey EW, Goodwin CR, Jusu\u00e9-Torres I, Rigamonti D. The utility of computed tomography in shunted patients with idiopathic intracranial hypertension presenting to the emergency department. World Neurosurg. 2015;84(6):1852\u20131856. doi:10.1016\/j.wneu.2015.08.008"},{"issue":"13","key":"b6","series-title":"Neurology","first-page":"1159","article-title":"Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children","volume":"81","author":"Friedman DI","year":"2013","unstructured":"Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology. 2013;81(13):1159\u20131165. doi:10.1212\/WNL.0b013e3182a55f17"},{"issue":"1","key":"b7","series-title":"Lancet Neurol","first-page":"78","article-title":"Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions","volume":"15","author":"Markey KA","year":"2016","unstructured":"Markey KA, Mollan SP, Jensen RH, Sinclair AJ. Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions. Lancet Neurol. 2016;15(1):78\u201391. doi:10.1016\/S1474-4422(15)00298-7"},{"issue":"12","key":"b8","series-title":"Int J Mol Sci","first-page":"28979","article-title":"Advances in intracranial pressure monitoring and its significance in managing traumatic brain injury","volume":"16","author":"Kawoos U","year":"2015","unstructured":"Kawoos U, McCarron RM, Auker CR, Chavko M. Advances in intracranial pressure monitoring and its significance in managing traumatic brain injury. Int J Mol Sci. 2015;16(12):28979\u201328997. doi:10.3390\/ijms161226146"},{"issue":"10","key":"b9","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1088","article-title":"Idiopathic intracranial hypertension: consensus guidelines on management","volume":"89","author":"Mollan SP","year":"2018","unstructured":"Mollan SP, Davies B, Silver NC, Idiopathic intracranial hypertension: consensus guidelines on management. J Neurol Neurosurg Psychiatry. 2018;89(10):1088\u20131100. doi:10.1136\/jnnp-2017-317440"},{"issue":"6","key":"b10","series-title":"J Neurol Neurosurg Psychiatry","first-page":"813","article-title":"Monitoring and interpretation of intracranial pressure","volume":"75","author":"Czosnyka M","year":"2004","unstructured":"Czosnyka M, Pickard JD. Monitoring and interpretation of intracranial pressure. J Neurol Neurosurg Psychiatry. 2004;75(6):813\u2013821. doi:10.1136\/jnnp.2003.033126"},{"issue":"12","key":"b11","series-title":"J Neurointerv Surg","first-page":"1162","article-title":"Correlation between intracranial pressure and venous sinus pressures in patients undergoing cerebral venography and manometry","volume":"13","author":"Lee K","year":"2021","unstructured":"Lee K, Kittel C, Aldridge JB, Wolfe SQ, Brown P, Fargen KM. Correlation between intracranial pressure and venous sinus pressures in patients undergoing cerebral venography and manometry. J Neurointerv Surg. 2021;13(12):1162\u20131166. doi:10.1136\/neurintsurg-2020-017161"},{"issue":"2","key":"b12","series-title":"Neurosurgery","first-page":"181","article-title":"The relationship between ventricular fluid pressure and body position in normal subjects and subjects with shunts: a telemetric study","volume":"26","author":"Chapman PH","year":"1990","unstructured":"Chapman PH, Cosman ER, Arnold MA. The relationship between ventricular fluid pressure and body position in normal subjects and subjects with shunts: a telemetric study. Neurosurgery. 1990;26(2):181\u2013189. doi:10.1097\/00006123-199002000-00001"},{"issue":"suppl 1","key":"b13","series-title":"J Neurotrauma","first-page":"S55","article-title":"Guidelines for the management of severe traumatic brain injury. VIII. Intracranial pressure thresholds","volume":"24","author":"Bratton SL","year":"2007","unstructured":"Bratton SL, Chestnut RM, Ghajar J, Guidelines for the management of severe traumatic brain injury. VIII. Intracranial pressure thresholds. J Neurotrauma. 2007;24(suppl 1):S55\u2013S58."},{"issue":"1","key":"b14","series-title":"Fluids Barriers CNS","first-page":"19","article-title":"Reference values for intracranial pressure and lumbar cerebrospinal fluid pressure: a systematic review","volume":"18","author":"Norager NH","year":"2021","unstructured":"Norager NH, Olsen MH, Pedersen SH, Riedel CS, Czosnyka M, Juhler M. Reference values for intracranial pressure and lumbar cerebrospinal fluid pressure: a systematic review. Fluids Barriers CNS. 2021;18(1):19. doi:10.1186\/s12987-021-00253-4"},{"issue":"3","key":"b15","series-title":"Neurocrit Care","first-page":"880","article-title":"A comprehensive perspective on intracranial pressure monitoring and individualized management in neurocritical care: results of a survey with global experts","volume":"41","author":"Brasil S","year":"2024","unstructured":"Brasil S, Godoy DA, Videtta W, A comprehensive perspective on intracranial pressure monitoring and individualized management in neurocritical care: results of a survey with global experts. Neurocrit Care. 2024;41(3):880\u2013892."},{"issue":"1","key":"b16","series-title":"Anesth Analg","first-page":"240","article-title":"Monitoring intracranial pressure in traumatic brain injury","volume":"106","author":"Smith M","year":"2008","unstructured":"Smith M. Monitoring intracranial pressure in traumatic brain injury. Anesth Analg. 2008;106(1):240\u2013248. doi:10.1213\/01.ane.0000297296.52006.8e"},{"issue":"1","key":"b17","series-title":"Neurocrit Care","first-page":"228","article-title":"Detection and management of elevated intracranial pressure in the treatment of acute community-acquired bacterial meningitis: a systematic review","volume":"41","author":"El-Hajj VG","year":"2024","unstructured":"El-Hajj VG, Pettersson I, Gharios M, Detection and management of elevated intracranial pressure in the treatment of acute community-acquired bacterial meningitis: a systematic review. Neurocrit Care. 2024;41(1):228\u2013243. doi:10.1007\/s12028-023-01937-5"},{"issue":"8","key":"b18","series-title":"CNS Neurosci Ther","first-page":"e14895","article-title":"Progress and recognition of idiopathic intracranial hypertension: a narrative review","volume":"30","author":"Zhou C","year":"2024","unstructured":"Zhou C, Zhou Y, Liu L, Progress and recognition of idiopathic intracranial hypertension: a narrative review. CNS Neurosci Ther. 2024;30(8):e14895. doi:10.1111\/cns.14895"},{"issue":"4","key":"b19","series-title":"J Neurol Neurosurg Psychiatry","first-page":"375","article-title":"Understanding the pathophysiology of idiopathic intracranial hypertension (IIH): a review of recent developments","volume":"95","author":"Colman BD","year":"2024","unstructured":"Colman BD, Boonstra F, Nguyen MN, Understanding the pathophysiology of idiopathic intracranial hypertension (IIH): a review of recent developments. J Neurol Neurosurg Psychiatry. 2024;95(4):375\u2013383. doi:10.1136\/jnnp-2023-332222"},{"issue":"5","key":"b20","series-title":"J Neurol Neurosurg Psychiatry","first-page":"488","article-title":"Update on the pathophysiology and management of idiopathic intracranial hypertension","volume":"83","author":"Biousse V","year":"2012","unstructured":"Biousse V, Bruce BB, Newman NJ. Update on the pathophysiology and management of idiopathic intracranial hypertension. J Neurol Neurosurg Psychiatry. 2012;83(5):488\u2013494. doi:10.1136\/jnnp-2011-302029"},{"issue":"4","key":"b21","series-title":"Ther Adv Neurol Disord","first-page":"317","article-title":"The diagnosis and management of idiopathic intracranial hypertension and the associated headache","volume":"9","author":"Jensen RH","year":"2016","unstructured":"Jensen RH, Radojicic A, Yri H. The diagnosis and management of idiopathic intracranial hypertension and the associated headache. Ther Adv Neurol Disord. 2016;9(4):317\u2013326. doi:10.1177\/1756285616635987"},{"key":"b22","series-title":"J Clin Neurosci","first-page":"172","article-title":"Idiopathic intracranial hypertension: pathophysiology, diagnosis and management","volume":"95","author":"Wang MTM","year":"2022","unstructured":"Wang MTM, Bhatti MT, Danesh-Meyer HV. Idiopathic intracranial hypertension: pathophysiology, diagnosis and management. J Clin Neurosci. 2022;95:172\u2013179. doi:10.1016\/j.jocn.2021.11.029"},{"issue":"7","key":"b23","series-title":"Life (Basel)","first-page":"718","article-title":"Awareness, diagnosis and management of idiopathic intracranial hypertension","volume":"11","author":"Jensen RH","year":"2021","unstructured":"Jensen RH, Vukovic-Cvetkovic V, Korsbaek JJ, Wegener M, Hamann S, Beier D. Awareness, diagnosis and management of idiopathic intracranial hypertension. Life (Basel). 2021;11(7):718. doi:10.3390\/life11070718"},{"issue":"3","key":"b24","series-title":"J Neuroophthalmol","first-page":"202","article-title":"Short-term continuous intraparenchymal intracranial pressure monitoring in presumed idiopathic intracranial hypertension","volume":"31","author":"Warden KF","year":"2011","unstructured":"Warden KF, Alizai AM, Trobe JD, Hoff JT. Short-term continuous intraparenchymal intracranial pressure monitoring in presumed idiopathic intracranial hypertension. J Neuroophthalmol. 2011;31(3):202\u2013205. doi:10.1097\/WNO.0b013e3182183c8d"},{"issue":"1","key":"b25","series-title":"BMC Neurol","first-page":"343","article-title":"Long-term telemetric intracranial pressure monitoring for diagnosis and therapy optimisation of idiopathic intracranial hypertension","volume":"21","author":"Velazquez Sanchez VF","year":"2021","unstructured":"Velazquez Sanchez VF, Al Dayri G, Tschan CA. Long-term telemetric intracranial pressure monitoring for diagnosis and therapy optimisation of idiopathic intracranial hypertension. BMC Neurol. 2021;21(1):343. doi:10.1186\/s12883-021-02349-8"},{"issue":"6","key":"b26","series-title":"Otolaryngol Head Neck Surg","first-page":"1061","article-title":"Increased intracranial pressure in spontaneous CSF leak patients is not associated with papilledema","volume":"151","author":"Aaron G","year":"2014","unstructured":"Aaron G, Doyle J, Vaphiades MS, Riley KO, Woodworth BA. Increased intracranial pressure in spontaneous CSF leak patients is not associated with papilledema. Otolaryngol Head Neck Surg. 2014;151(6):1061\u20131066. doi:10.1177\/0194599814551122"},{"issue":"4","key":"b27","series-title":"J Neuroophthalmol","first-page":"487","article-title":"Do most patients with a spontaneous cerebrospinal fluid leak have idiopathic intracranial hypertension?","volume":"39","author":"Bidot S","year":"2019","unstructured":"Bidot S, Levy JM, Saindane AM, Oyesiku NM, Newman NJ, Biousse V. Do most patients with a spontaneous cerebrospinal fluid leak have idiopathic intracranial hypertension? J Neuroophthalmol. 2019;39(4):487\u2013495. doi:10.1097\/WNO.0000000000000761"},{"issue":"4","key":"b28","series-title":"J Neuroophthalmol","first-page":"330","article-title":"Primary spontaneous cerebrospinal fluid leaks and idiopathic intracranial hypertension","volume":"33","author":"P\u00e9rez MA","year":"2013","unstructured":"P\u00e9rez MA, Bialer OY, Bruce BB, Newman NJ, Biousse V. Primary spontaneous cerebrospinal fluid leaks and idiopathic intracranial hypertension. J Neuroophthalmol. 2013;33(4):330\u2013337. doi:10.1097\/WNO.0b013e318299c292"},{"issue":"1","key":"b29","series-title":"J Headache Pain","first-page":"27","article-title":"Intracranial pressure monitoring in patients with spontaneous onset of orthostatic headache","volume":"26","author":"D\u2019Antona L","year":"2025","unstructured":"D\u2019Antona L, Cheema S, Mehta D, Intracranial pressure monitoring in patients with spontaneous onset of orthostatic headache. J Headache Pain. 2025;26(1):27. doi:10.1186\/s10194-024-01928-7"},{"issue":"9","key":"b30","series-title":"Acta Neurochir (Wien)","first-page":"1813","article-title":"The role of ICP monitoring in patients with persistent cerebrospinal fluid leak following spinal surgery: a case series","volume":"158","author":"Craven C","year":"2016","unstructured":"Craven C, Toma AK, Khan AA, Watkins LD. The role of ICP monitoring in patients with persistent cerebrospinal fluid leak following spinal surgery: a case series. Acta Neurochir (Wien). 2016;158(9):1813\u20131819. doi:10.1007\/s00701-016-2882-5"},{"issue":"1","key":"b31","series-title":"Int Forum Allergy Rhinol","first-page":"71","article-title":"Perioperative continuous cerebrospinal fluid pressure monitoring in patients with spontaneous cerebrospinal fluid leaks","volume":"5","author":"Xie YJ","year":"2015","unstructured":"Xie YJ, Shargorodsky J, Lane AP, Perioperative continuous cerebrospinal fluid pressure monitoring in patients with spontaneous cerebrospinal fluid leaks. Int Forum Allergy Rhinol. 2015;5(1):71\u201377. doi:10.1002\/alr.21424"},{"issue":"6","key":"b32","series-title":"J Neurosurg","first-page":"1503","article-title":"Hypertensive slit ventricle syndrome: pseudotumor cerebri with a malfunctioning shunt?","volume":"119","author":"Bateman GA","year":"2013","unstructured":"Bateman GA. Hypertensive slit ventricle syndrome: pseudotumor cerebri with a malfunctioning shunt? J Neurosurg. 2013;119(6):1503\u20131510. doi:10.3171\/2013.7.JNS13390"},{"issue":"5","key":"b33","series-title":"J Neurosurg","first-page":"1076","article-title":"Intracranial pressure monitoring in pediatric and adult patients with hydrocephalus and tentative shunt failure: a single-center experience over 10 years in 146 patients","volume":"122","author":"S\u00e6hle T","year":"2015","unstructured":"S\u00e6hle T, Eide PK. Intracranial pressure monitoring in pediatric and adult patients with hydrocephalus and tentative shunt failure: a single-center experience over 10 years in 146 patients. J Neurosurg. 2015;122(5):1076\u20131086. doi:10.3171\/2014.12.JNS141029"},{"issue":"4","key":"b34","series-title":"Neurosurg Focus","first-page":"E10","article-title":"Continuous intracranial pressure monitoring via the shunt reservoir to assess suspected shunt malfunction in adults with hydrocephalus","volume":"22","author":"Geocadin RG","year":"2007","unstructured":"Geocadin RG, Varelas PN, Rigamonti D, Williams MA. Continuous intracranial pressure monitoring via the shunt reservoir to assess suspected shunt malfunction in adults with hydrocephalus. Neurosurg Focus. 2007;22(4):E10. doi:10.3171\/foc.2007.22.4.12"},{"issue":"1","key":"b35","series-title":"Curr Opin Neurol","first-page":"92","article-title":"Advances in the understanding of headache in idiopathic intracranial hypertension","volume":"32","author":"Mollan SP","year":"2019","unstructured":"Mollan SP, Hoffmann J, Sinclair AJ. Advances in the understanding of headache in idiopathic intracranial hypertension. Curr Opin Neurol. 2019;32(1):92\u201398. doi:10.1097\/WCO.0000000000000651"},{"key":"b36","series-title":"World Neurosurg","first-page":"167","article-title":"Use of intracranial pressure monitoring frequently refutes diagnosis of idiopathic intracranial hypertension","volume":"104","author":"Xu DS","year":"2017","unstructured":"Xu DS, Hlubek RJ, Mulholland CB, Knievel KL, Smith KA, Nakaji P. Use of intracranial pressure monitoring frequently refutes diagnosis of idiopathic intracranial hypertension. World Neurosurg. 2017;104:167\u2013170. doi:10.1016\/j.wneu.2017.04.080"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/60\/1\/article-pE7.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/60\/1\/article-pE7.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/60\/1\/article-pE7.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:39:20Z","timestamp":1780130360000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/60\/1\/article-pE7.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":72,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2025.10.focus25867","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,1]]}}}