Management of idiopathic intracranial hypertension in pregnancy

2021 ◽  
pp. 1753495X2110213
Author(s):  
LA Byth ◽  
K Lust ◽  
RL Jeffree ◽  
M Paine ◽  
L Voldanova ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Vision Loss ◽  
De Novo ◽  
Reproductive Age ◽  
Premature Delivery ◽  
Hormonal Changes ◽  
Hypertension In Pregnancy ◽  
Ventriculoperitoneal Shunting ◽  
In Pregnancy

Idiopathic intracranial hypertension is more common among women of reproductive age and is often encountered in pregnancy, either pre-existing and exacerbated by pregnancy-associated weight gain and hormonal changes or arising de novo. We report the case of a 33-year-old woman with progressive visual loss and intractable headache from 20 weeks’ gestation requiring ventriculoperitoneal shunting during pregnancy. The risk of permanent maternal vision loss raises complex management dilemmas, when this must be balanced with the fetal and neonatal risks of treatment and possible premature delivery.

Idiopathic intracranial hypertension in pregnancy

2014 ◽  
Vol 16 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Lakshmi Thirumalaikumar ◽  
Kalaivani Ramalingam ◽  
Tom Heafield
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Hypertension In Pregnancy ◽  
In Pregnancy

scholarly journals Comparison of Lumboperitoneal Shunt and Stereotactic Ventriculoperitoneal Shunt in the Treatment of Refractory Idiopathic Intracranial Hypertension: A Case Report and Literature Review

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Gao C ◽  
Zhang H ◽  
Fu J
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Vision Loss ◽  
Therapeutic Effects ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Clinical Prognosis ◽  
Slit Ventricle Syndrome ◽  
Ventriculoperitoneal Shunting

Idiopathic Intracranial Hypertension (IIH) or Pseudotumor Cerebri (PTC) is a disorder of young obese females and characterized by headache, papilledema and raised intracranial pressure. However, it is in the absence of known pathological cause. Due to the uncertainty of etiology, it may lead to misdiagnosis and grave clinical prognosis. IIH is typically treated with Lumboperitoneal Shunting (LPS) and Ventriculoperitoneal Shunting (VPS), but shunts are prone to dysfunctions and infection, resulting in recurrent headaches in many patients after this treatment. We report a case of 41-year-old obese female (BMI: 30.9) with IIH, who has a history of hypertension (Blood pressure: 150/100 mmHg) and elevated intracranial pressure (Open pressure: 450 mmH2 O). After the failure of several medical treatments, the patient was offered LPS because of vision loss and headache, but the postoperative symptoms (intermittent headache, mainly total craniocerebral prickling pain with neck and shoulder pain) were not significantly relieved for 11 years. Therefore, considering the blockage of the primary shunt tube and the small ventricle in the patient, it has difficulty in puncture ventricle puncture. We have to treat with the stereotactic VPS (SVPS) for her exacerbation symptoms. More surprisingly, the hypertension was in the normal range (<115/80 mmHg) after the surgery (without taking antihypertensive medication). To compare the surgical therapeutic effects and complications of LPS and the SVPS in the treatment of idiopathic intracranial hypertension. Cerebrospinal Fluid (CSF) diversion with VPS or LPS is usually performed when the main symptom is vision loss; it also stabilizes headache and papilledema. LPS significantly alleviates symptoms in the short term, but due to excessive shunt of LPS for a long time, it is easy to be complicated with Chiari malformation and slit ventricle syndrome. Therefore, we encourage operating the SVPS on our patients for the favorable long-term outcome.

scholarly journals Comparison of Lumbarperitoneal Shunt with the Stereotactic Ventriculoperitoneal Shunt for the Treatment of Refractory Idiopathic Intracranial Hypertension：A Case Report and Literature Review

2021 ◽  
Author(s):  
Changsong Gao ◽  
Hongtao Zhang ◽  
Jidi Fu
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Ventriculoperitoneal Shunt ◽  
Idiopathic Intracranial Hypertension ◽  
Vision Loss ◽  
Therapeutic Effects ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Slit Ventricle Syndrome ◽  
Ventriculoperitoneal Shunting

Abstract BackgroundIdiopathic intracranial hypertension (IIH) or pseudotumor cerebri (PTC), is a disorder of young obese females and characterized by headache, papilledema with raised intracranial pressure in the absence of known pathological cause. Due to the uncertainty of etiology, it may lead to misdiagnosis and poor outcome. IIH is typically treated with shunts (lumbarperitoneal and ventriculoperitoneal shunting), but shunts are prone to malfunction and infection, resulting in many patients experiencing recurrent headaches post-treatment. Case presentationWe report a case of 41 years old obese female (BMI:30.9) with IIH who exhibited a history of hypertension (BP:150/100mmHg) and documented elevated intracranial pressure (OP:450mm H2O). After the failure of several medical treatments, the patient was offered LPS due to vision loss and headache, but postoperative symptoms (intermittent headache-mainly whole craniocerebral prickling pain accompanied by neck and shoulder pain) did not significantly relieve lasting for 11 years. Therefore, we considered the blockage of the primary shunt tube in the patient, and the patient with a small ventricle leads to some difficulty in ventricle puncture, then we had to treated with the stereotactic VPS（VPS）for her exacerbation symptoms. More surprisingly, the hypertension was within the normal range (<115/80mmHg) after the surgery (without antihypertensive medication).Purpose To compare the surgical therapeutic effects and complications of lumbarperitoneal shunt (LPS) and the stereotactic ventriculoperitoneal shunt (SVPS) for idiopathic intracranial hypertension.ConclusionCSF diversion with a ventriculoperitoneal shunt (VPS) or lumboperitoneal shunt (LPS) is usually performed when the main symptom is vision loss and it also stabilizes headache and papilledema. LPS significantly alleviates symptoms in the short term, but due to excessive shunt of LPS long time, it is easy to be complicated with iatrogenic Chiari malformation and slit ventricle syndrome. Therefore, we are encouraged to apply the SVPS on our patients for the favorable long-term outcome.

scholarly journals Idiopathic Intracranial Hypertension in Pregnancy Treated with Serial Lumbar Punctures

2011 ◽  
Vol 02 (01) ◽  
pp. 9-12 ◽  
Author(s):  
Manasi Badve ◽  
Matthew J. McConnell ◽  
Tanmay Shah ◽  
Kristin M. Ondecko-Ligda ◽  
George W. Poutous ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Hypertension In Pregnancy ◽  
In Pregnancy

scholarly journals Intracranial Venous Sinus Stenting in Idiopathic Intracranial Hypertension: A Case Report and Review of the Literature

2021 ◽  
Vol 11 (3) ◽  
pp. 382
Author(s):  
Dinesh Ramanathan ◽  
Zachary D. Travis ◽  
Emmanuel Omosor ◽  
Taylor Wilson ◽  
Nikhil Sahasrabudhe ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Vision Loss ◽  
Transverse Sinus ◽  
Venous Sinus ◽  
Subdural Hygroma ◽  
Presenting Symptoms ◽  
Minimal Improvement ◽  
Sinus Stenosis ◽  
Work Up

We describe a case of severe headaches, double vision, and progressive vision loss secondary to a ruptured intracranial cyst (IAC) in a 31-year-old woman with no relevant past medical history. The case is peculiar because drainage of the subdural hygroma led to a minimal improvement in vision with persistent elevated intracranial pressure (ICP). Further exploration revealed transverse sinus stenosis necessitating stenting. Evaluation post-stenting showed marked reduction of ICP and improvement in symptoms. This report underscores the importance of comprehensive work-up and suspicion of multiple underlying etiologies that may be crucial to complete resolution of presenting symptoms in some cases. We provide an overview of the clinical indications and evidence for venous sinus stenting in treating idiopathic intracranial hypertension (IIH).

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