THE RATIONALE OF LUMBOPERITONEAL SHUNT: IN THE MANAGEMENT OF BENIGN INTRACRANIAL HYPERTENSION
Main Article Content
Keywords
Benign intracranial hypertension, fundus edema, CSF pressure, lumboperitoneal shunt
Abstract
Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri (PTC), is characterized by elevated intracranial pressure in patients with normal cerebrospinal fluid (CSF) composition and neuroimaging1. IIH predominantly affects women and has a notable association with obesity. The annual incidence rate is 0.9 per 100,000 in the general population, with the highest incidence rate of 7.9 occurring among obese women aged 15 to 44 years 2. The accepted criteria for diagnosing IIH include raised intracranial pressure without hydrocephalus or mass lesion, normal CSF composition, and no identifiable underlying etiology3.
References
2.Johnson, L. N., Krohel, G. B., Madsen, R. W., & March, G. A. (1998). The role of weight loss and acetazolamide in the treatment of idiopathic intracranial hypertension (pseudotumor cerebri). Ophthalmology, 105(12), 2313–2317. doi:10.1016/s0161-6420(98)91234-9
3. Mollan SP, Davies B, Silver NC, Shaw S, Mallucci CL, Wakerley BR et al. Idiopathic intracranial hypertension: consensus guidelines on management. J Neurol Neurosurg Psychiatry. 2018 Oct;89(10):1088-1100.
4. Eggenberger, E. R., Miller, N. R., & Vitale, S. (1996). Lumboperitoneal shunt for the treatment of pseudotumor cerebri. Neurology, 46(6), 1524–1530. doi:10.1212/wnl.46.6.1524
5. Corbett JJ, Savino PJ, Thompson HS, et al. Visual loss in pseudotumor cerebri. Follow-up of 57 patients from five to 41 years and a profile of 14 patients with permanent severe visual loss. Arch Neurol 1982;39:461–74.
6.Wall M, George D. Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain 1991;114:155–80.
7. Lessell S. Pediatric pseudotumor cerebri (idiopathic intracranial hypertension). Surv Ophthalmol 1992;37:155–66.
8. El-Saadany, W. F., Farhoud, A., & Zidan, I. (2011). Lumboperitoneal shunt for idiopathic intracranial hypertension: patients’ selection and outcome. Neurosurgical Review, 35(2), 239–244.
9. Binder D, Horton JC, Lawton MT, McDermott MW (2004) Idiopathic intracranial hypertension. Neurosurgery 54:538–552
10. Sugerman HJ, DeMaria EJ, Felton WL et al (1997) Increased intra-abdominal pressure and cardiac filling pressures in obesity associated pseudotumor cerebri. Neurology 49:507–511
11. Cognard C, Casasco A, Toevi M et al (1998) Dural arteriovenous fistulas as a cause of intracranial hypertension due to impairment of cranial venous outflow. J Neurol Neurosurg Psychiatry 65:308– 316
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Haider Ali
Registrar Neurosurgery lady reading hospital Peshawar