Lumbo-Oeritoneal Shunt For Treatment Of Pseudotumor Cerebri

The most dangerous complication of BIH is visual loss; thereforemanagement should be directed to prevent this serious complication.The most accepted surgical options for treatment of this disease areoptic nerve sheath fenestration and lumboperitoneal shunt.This study was conducted on 30 patients with BIH treated withlumboperitoneal shunt at the neurosurgery department, Zagazig universityhospitals.Analysis of the results of this study revealed that:The ages ranged from 18 to 48 years and 80% of them were female.Headache was the most common presenting symptom followed byblurring of vision and papilledema was the most common signfollowed by 6th cranial nerve palsy.Neuroimaging of the patients revealed that most of patients hadmorphologically normal CT brain while small ventricle and/orcompressed cistern were found in some patients while empty sella wasfound only in two patients.Frequent monitoring of visual function of patient with BIH isnecessary for early detection of visual function deterioration.The indication of surgery was severe visual loss in the initial visit orpersistent headache and deterioration of vision despite full medicaltherapy.Postoperative evaluation and follow up of symptoms and signsrevealed that:Headache, blurring of vision, tinnitus and transient visual obscurationimproved in most patients while diplopia and 6th nerve palsy improvedin all patients.Lumboperitoneal shunt prevented any deterioration in the visual acuityand improved visual field in most cases.The greatest drawback of lumboperitoneal shunt was shuntobstruction and the need for shunt revision while the most dangerouscomplication was meningitis which occurred in two patients.