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J Howard, RE Appen; Ventriculoperitoneal Shunting for Pseudotumor Cerebri . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2641.
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Purpose: Since there are few reports in the literature evaluating the use of ventriculoperitoneal shunts in patients with pseudotumor cerebri, we present our experience with treating six patients. Methods: This is a retrospective analysis of six patients whose pseudotumor cerebri required surgical treatment that was provided by ventriculoperitoneal shunting. The data obtained by chart review included assessment of visual acuity, visual field testing, optic disc appearance, and symptoms of elevated intracranial pressure, both pre- and post-operatively. Results: Follow-up of the patients from the date of surgery ranged from 7 to 24 months with an average of 14 months. Postoperative visual acuity was improved or stable in 11 of 12 eyes (92%). Visual fields were improved or stable in 10 of 12 eyes (83%). Optic disc elevation was improved in 12 of 12 eyes (100%). Symptoms of elevated intracranial pressure, including headache and diplopia, improved or were stable in all of the patients. The only surgical complication was a minor incision dehiscence in one patient. Conclusion: In six patients with pseudotumor cerebri, ventriculoperitoneal shunting was followed by prompt resolution of papilledema and good improvement of symptoms of elevated intracranial pressure. The patients also benefited from improved visual function. This procedure can be considered as a treatment option in patients with pseudotumor cerebri whose vision is worsening despite medical therapy.
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