Evolution of Treatment Paradigms in Idiopathic Intracranial Hypertension: A 25-Year Bibliometric Analysis (2000–2024)

Abstract The treatment of idiopathic intracranial hypertension has undergone major changes over the past twenty years, with a shift in the treatment paradigm from medical treatment to surgical and endovascular interventions. This study aims to conduct a bibliometric analysis of scientific publications on idiopathic intracranial hypertension (IIH) and associated cerebral venous outflow disorders between 2000 and 2024. We conducted a search in the Web of Science Core Collection database using the terms ‘idiopathic intracranial hypertension’, ‘pseudotumor cerebri’, and related symptoms or medical treatment terms. English articles and reviews (2000–2024) (n = 958) were analysed using bibliometric methods, including co-citation networks, thematic mapping, and citation burst analysis, via the Bibliometrix package in R. The annual number of publications increased from 1–2 (before 2000) to 90–100 (2024). Retrospective cohort studies increased from 13.6% to 29.7%, while case reports decreased from 44% (2000–2009) to 29.3% (2010–2024). Terminologically, the use of “idiopathic intracranial hypertension” (n = 524) overtook “pseudotumor cerebri” (n = 359). In interventional studies, publications on venous sinus stenting increased from 30% (2000–2005) to 45–50% (2021–2024). Citation burst analysis showed that the terms “venous sinus stenosis” and “venous sinus stenting” became dominant terms simultaneously with the highest burst power (4.2 and 3.8) in 2023–2024. The shift from pseudotumor cerebri to “idiopathic intracranial hypertension” may indicate a growing awareness of the clinical severity of the disease. The research focus has shifted from diagnosis and pathophysiology to surgical and endovascular treatments, with venous sinus stenting becoming increasingly important. However, randomised controlled trials remain limited (3.9%), highlighting the need for prospective, multicentre studies to validate evolving interventional approaches.