Persistent shunt dependency in children treated with CSF diversion for idiopathic intracranial hypertension (IIH)

2019 ◽  
Vol 162 (1) ◽  
pp. 39-42
Author(s):  
Tryggve Lundar ◽  
Bernt Johan Due-Tønnessen
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Shunt Dependency ◽  
Csf Diversion

scholarly journals Will CSF Diversion in Patients with Idiopathic Intracranial Hypertension (IIH) Lead to Long-Lasting Shunt Dependency?

2021 ◽  
Author(s):  
Tryggve Lundar ◽  
Bernt Johan Due-Tønnessen
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Shunt Failure ◽  
Shunt Treatment ◽  
Long Time ◽  
Shunt Dependency ◽  
Csf Diversion

Long-term shunt dependency rates in patients treated for IIH with CSF diversion have not been established. We therefore present our experience with 5 children shunted for IIH during the years 1984–2000 with very long-time follow-up. Three out of these patients have experienced late or very late episodes of severe shunt failure during the second or third decade after initial shunt treatment. They were all boys and may not be representative for IIH patients as a whole. Three of them appear, however, to be permanently shunt dependent, indicating that long-term shunt-dependency in children treated for IIH with CSF diversion may be more common than previously expected.

scholarly journals Idiopathic intracranial hypertension: a review of diagnosis and management

2021 ◽  
Vol 20 (4) ◽  
pp. 16-20
Author(s):  
Samuel Jeffery ◽  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Surgical Interventions ◽  
Optic Nerve Sheath Fenestration ◽  
Nerve Sheath ◽  
Prevalence Of Obesity ◽  
Csf Diversion ◽  
Disease Modifying ◽  
Disease Modifying Treatment

With the increasing prevalence of obesity, the incidence of idiopathic intracranial hypertension (IIH) is rising. Headache and threat to vision are the predominant features and the principal cause of morbidity and reduced quality of life. Identification of papilloedema must prompt urgent investigation to exclude any underlying cause and management should be multi-disciplinary, focusing on protecting vision and reducing headache burden. Weight loss is the most effective and only disease modifying treatment for IIH but surgical interventions may need to be considered in some patients. Whilst optic nerve sheath fenestration and CSF diversion have established roles in protecting vision, there is increasing interest in venous sinus stenting and bariatric surgery as additional interventions that may have efficacy in the treatment of this condition.

Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review

Cephalalgia ◽  
2011 ◽  
Vol 31 (16) ◽  
pp. 1627-1633 ◽  
Author(s):  
Alexandra J Sinclair ◽  
Sarin Kuruvath ◽  
Diptasri Sen ◽  
Peter G Nightingale ◽  
Michael A Burdon ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Visual Acuity ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Low Pressure ◽  
Shunt Revision ◽  
Common Symptom ◽  
Csf Diversion ◽  
Low Pressure Headache ◽  
Pressure Headache

Background: The role of cerebrospinal fluid (CSF) diversion in treating idiopathic intracranial hypertension (IIH) is disputed. Method: We conducted a 10-year, retrospective case note review to evaluate the effects of CSF diversion in IIH. Symptoms, signs and details of shunt type, complications and revisions were documented at baseline, 6, 12 and 24 months post-operatively. Results: Fifty-three IIH patients were shunted [predominantly lumboperitoneal (92%)]. The most common symptom pre-surgery was headache (96%). Post-operatively, significantly fewer patients experienced declining vision and visual acuity improved at 6 ( p = 0.001) and 12 months ( p = 0.016). Headache continued in 68% at 6 months, 77% at 12 months and 79% at 2 years post-operatively. Additionally, post-operative low-pressure headache occurred in 28%. Shunt revision occurred in 51% of patients, with 30% requiring multiple revisions. Conclusion: We conclude that CSF diversion reduces visual decline and improves visual acuity. Unfortunately, headache remained in the majority of patients and low-pressure headache frequently complicated surgery. Over half of the patients required shunt revision with the majority of these requiring multiple revisions. We suggest that CSF shunting should be conducted as a last resort in those with otherwise untreatable, rapidly declining vision. Alternative treatments, such as weight reduction, may be more effective with less associated morbidity.

scholarly journals Persistent shunt dependency and very late shunt failure in a 3-year-old boy with idiopathic intracranial hypertension (IIH)

2016 ◽  
Vol 33 (2) ◽  
pp. 213-215 ◽  
Author(s):  
Anne Henriette Paulsen ◽  
Bernt Johan Due-Tønnessen ◽  
Tryggve Lundar ◽  
Karl-Fredrik Lindegaard
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Shunt Failure ◽  
Shunt Dependency

scholarly journals P.127 Single centre review of lumboperitoneal shunt outcomes

2018 ◽  
Vol 45 (s2) ◽  
pp. S49-S49
Author(s):  
A Persad ◽  
K Meguro
Keyword(s):  
Intracranial Hypertension ◽  
Treatment Modality ◽  
Idiopathic Intracranial Hypertension ◽  
Laparoscopic Approach ◽  
Normal Pressure ◽  
Peritoneal Catheter ◽  
Single Centre ◽  
Lumboperitoneal Shunt ◽  
Csf Diversion ◽  
Established Treatment

Background: Ventriculoperitoneal (VP) shunts are an established treatment modality for CSF diversion. An alternative to VP shunting is lumboperitoneal (LP) shunting. There is a paucity of evidence on LP shunt use in the literature, but available studies demonstrate that it is a safer and similarly efficacious method for conditions such as normal pressure hydrocephalies (NPH) and idiopathic -intracranial hypertension (IIH). Methods: Ventriculoperitoneal (VP) shunts are an established treatment modality for CSF diversion. An alternative to VP shunting is lumboperitoneal (LP) shunting. There is a paucity of evidence on LP shunt use, but available studies demonstrate that it is a safer and similarly efficacious method for conditions such as normal pressure hydrocephalies (NPH) and idiopathic intracranial hypertension (IIH). Results: 95 patients were treated with lumboperitoneal shunt, 71 of which were for hydrocephalus and 24 for IIH. 39 male and 58 female patients were included with mean age 55 (range from 20 to 96 years old). 26 patients had laparoscopic placement of the peritoneal catheter. Mechanical issues with distal end was less with laparoscopic approach. Conclusions: We will review disease-specific scores for NPH and IIH, and compare laparoscopic with non-laparoscopic placement of peritoneal catheter. We will also compare outcomes and complications with rates for VP shunting.

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