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Procedures Serial lumbar punctures Temporary relief of pressure Not a long-term solution May be used while medications take effect Surgery (for severe or progressive cases) Optic nerve sheath fenestration Creates window in optic nerve covering Protects vision May not help headache Shunting procedures Ventriculoperitoneal (VP) shunt or lumboperitoneal shunt Drains excess CSF Helps both vision and headache May need revision over time Venous sinus stenting For patients with venous sinus stenosis May reduce pressure Specialized centers Monitoring Regular follow-up is essential: Visual field testing : every few months or more often if unstable OCT : tracks nerve fiber layer Clinical exam : checking papilledema Symptom assessment Weight monitoring When to Go to the ER for IIH Go to the emergency department the same day if vision is clearly worsening, transient blackouts are becoming frequent, new double vision appears, or papilledema has been described as severe