Pseudotumor cerebri surgery: Difference between revisions

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==Surgery==
==Surgery==
Surgical options are:
Surgical options are:
* Optic nerve sheath fenestration
** In IIH patients with papilledema, optic nerve sheath fenestration (ONSF) can improve [[Vision loss|visual loss]].<ref name="pmid22423118">{{cite journal |vauthors=Biousse V, Bruce BB, Newman NJ |title=Update on the pathophysiology and management of idiopathic intracranial hypertension |journal=J. Neurol. Neurosurg. Psychiatry |volume=83 |issue=5 |pages=488–94 |date=May 2012 |pmid=22423118 |pmc=3544160 |doi=10.1136/jnnp-2011-302029 |url=}}</ref>


==== Optic nerve sheath fenestration ====
* Shunting
In IIH patients with papilledema, optic nerve sheath fenestration (ONSF) can improve [[Vision loss|visual loss]].<ref name="pmid22423118">{{cite journal |vauthors=Biousse V, Bruce BB, Newman NJ |title=Update on the pathophysiology and management of idiopathic intracranial hypertension |journal=J. Neurol. Neurosurg. Psychiatry |volume=83 |issue=5 |pages=488–94 |date=May 2012 |pmid=22423118 |pmc=3544160 |doi=10.1136/jnnp-2011-302029 |url=}}</ref>
** [[Ventriculoperitoneal shunt|Ventriculoperitoneal]] and lumboperitoneal shunting can reduce [[Headache|headaches]], [[diplopia]], [[papilledema]] and [[Vision loss|visual loss]] in [[Idiopathic intracranial hypertension|IIH]] patients.<ref name="pmid22423118">{{cite journal |vauthors=Biousse V, Bruce BB, Newman NJ |title=Update on the pathophysiology and management of idiopathic intracranial hypertension |journal=J. Neurol. Neurosurg. Psychiatry |volume=83 |issue=5 |pages=488–94 |date=May 2012 |pmid=22423118 |pmc=3544160 |doi=10.1136/jnnp-2011-302029 |url=}}</ref><ref name="pmid24820047">{{cite journal |vauthors=Fonseca PL, Rigamonti D, Miller NR, Subramanian PS |title=Visual outcomes of surgical intervention for pseudotumour cerebri: optic nerve sheath fenestration versus cerebrospinal fluid diversion |journal=Br J Ophthalmol |volume=98 |issue=10 |pages=1360–3 |date=October 2014 |pmid=24820047 |doi=10.1136/bjophthalmol-2014-304953 |url=}}</ref><ref name="pmid9305333">{{cite journal |vauthors=Burgett RA, Purvin VA, Kawasaki A |title=Lumboperitoneal shunting for pseudotumor cerebri |journal=Neurology |volume=49 |issue=3 |pages=734–9 |date=September 1997 |pmid=9305333 |doi= |url=}}</ref><ref name="pmid2089940">{{cite journal |vauthors=Lundar T, Nornes H |title=Pseudotumour cerebri-neurosurgical considerations |journal=Acta Neurochir Suppl (Wien) |volume=51 |issue= |pages=366–8 |date=1990 |pmid=2089940 |doi= |url=}}</ref>


==== Shunting ====
* Venous sinus stenting
[[Ventriculoperitoneal shunt|Ventriculoperitoneal]] and lumboperitoneal shunting can reduce [[Headache|headaches]], [[diplopia]], [[papilledema]] and [[Vision loss|visual loss]] in [[Idiopathic intracranial hypertension|IIH]] patients.<ref name="pmid22423118">{{cite journal |vauthors=Biousse V, Bruce BB, Newman NJ |title=Update on the pathophysiology and management of idiopathic intracranial hypertension |journal=J. Neurol. Neurosurg. Psychiatry |volume=83 |issue=5 |pages=488–94 |date=May 2012 |pmid=22423118 |pmc=3544160 |doi=10.1136/jnnp-2011-302029 |url=}}</ref><ref name="pmid24820047">{{cite journal |vauthors=Fonseca PL, Rigamonti D, Miller NR, Subramanian PS |title=Visual outcomes of surgical intervention for pseudotumour cerebri: optic nerve sheath fenestration versus cerebrospinal fluid diversion |journal=Br J Ophthalmol |volume=98 |issue=10 |pages=1360–3 |date=October 2014 |pmid=24820047 |doi=10.1136/bjophthalmol-2014-304953 |url=}}</ref><ref name="pmid9305333">{{cite journal |vauthors=Burgett RA, Purvin VA, Kawasaki A |title=Lumboperitoneal shunting for pseudotumor cerebri |journal=Neurology |volume=49 |issue=3 |pages=734–9 |date=September 1997 |pmid=9305333 |doi= |url=}}</ref><ref name="pmid2089940">{{cite journal |vauthors=Lundar T, Nornes H |title=Pseudotumour cerebri-neurosurgical considerations |journal=Acta Neurochir Suppl (Wien) |volume=51 |issue= |pages=366–8 |date=1990 |pmid=2089940 |doi= |url=}}</ref>
** We can perform venous stenting in patients with venous sinus stenosis on cerebral venography. This method can reduce [[Headache|headaches]] and visual problems.<ref name="pmid21799038">{{cite journal |vauthors=Ahmed RM, Wilkinson M, Parker GD, Thurtell MJ, Macdonald J, McCluskey PJ, Allan R, Dunne V, Hanlon M, Owler BK, Halmagyi GM |title=Transverse sinus stenting for idiopathic intracranial hypertension: a review of 52 patients and of model predictions |journal=AJNR Am J Neuroradiol |volume=32 |issue=8 |pages=1408–14 |date=September 2011 |pmid=21799038 |doi=10.3174/ajnr.A2575 |url=}}</ref><ref name="pmid22863980">{{cite journal |vauthors=Puffer RC, Mustafa W, Lanzino G |title=Venous sinus stenting for idiopathic intracranial hypertension: a review of the literature |journal=J Neurointerv Surg |volume=5 |issue=5 |pages=483–6 |date=September 2013 |pmid=22863980 |doi=10.1136/neurintsurg-2012-010468 |url=}}</ref>
 
==== Venous sinus stenting ====
We can perform venous stenting in patients with venous sinus stenosis on cerebral venography. This method can reduce [[Headache|headaches]] and visual problems.<ref name="pmid21799038">{{cite journal |vauthors=Ahmed RM, Wilkinson M, Parker GD, Thurtell MJ, Macdonald J, McCluskey PJ, Allan R, Dunne V, Hanlon M, Owler BK, Halmagyi GM |title=Transverse sinus stenting for idiopathic intracranial hypertension: a review of 52 patients and of model predictions |journal=AJNR Am J Neuroradiol |volume=32 |issue=8 |pages=1408–14 |date=September 2011 |pmid=21799038 |doi=10.3174/ajnr.A2575 |url=}}</ref><ref name="pmid22863980">{{cite journal |vauthors=Puffer RC, Mustafa W, Lanzino G |title=Venous sinus stenting for idiopathic intracranial hypertension: a review of the literature |journal=J Neurointerv Surg |volume=5 |issue=5 |pages=483–6 |date=September 2013 |pmid=22863980 |doi=10.1136/neurintsurg-2012-010468 |url=}}</ref>


==References==
==References==

Latest revision as of 14:55, 29 November 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Indications

Surgery is not the first-line treatment option for patients with pseudotumor cerebri. Surgery is usually reserved for patients with either:

Surgery

Surgical options are:

  • Optic nerve sheath fenestration
    • In IIH patients with papilledema, optic nerve sheath fenestration (ONSF) can improve visual loss.[2]
  • Venous sinus stenting
    • We can perform venous stenting in patients with venous sinus stenosis on cerebral venography. This method can reduce headaches and visual problems.[6][7]

References

  1. ↑ Corbett JJ, Thompson HS (October 1989). "The rational management of idiopathic intracranial hypertension". Arch. Neurol. 46 (10): 1049–51. PMID 2679506.
  2. ↑ 2.0 2.1 Biousse V, Bruce BB, Newman NJ (May 2012). "Update on the pathophysiology and management of idiopathic intracranial hypertension". J. Neurol. Neurosurg. Psychiatry. 83 (5): 488–94. doi:10.1136/jnnp-2011-302029. PMC 3544160. PMID 22423118.
  3. ↑ Fonseca PL, Rigamonti D, Miller NR, Subramanian PS (October 2014). "Visual outcomes of surgical intervention for pseudotumour cerebri: optic nerve sheath fenestration versus cerebrospinal fluid diversion". Br J Ophthalmol. 98 (10): 1360–3. doi:10.1136/bjophthalmol-2014-304953. PMID 24820047.
  4. ↑ Burgett RA, Purvin VA, Kawasaki A (September 1997). "Lumboperitoneal shunting for pseudotumor cerebri". Neurology. 49 (3): 734–9. PMID 9305333.
  5. ↑ Lundar T, Nornes H (1990). "Pseudotumour cerebri-neurosurgical considerations". Acta Neurochir Suppl (Wien). 51: 366–8. PMID 2089940.
  6. ↑ Ahmed RM, Wilkinson M, Parker GD, Thurtell MJ, Macdonald J, McCluskey PJ, Allan R, Dunne V, Hanlon M, Owler BK, Halmagyi GM (September 2011). "Transverse sinus stenting for idiopathic intracranial hypertension: a review of 52 patients and of model predictions". AJNR Am J Neuroradiol. 32 (8): 1408–14. doi:10.3174/ajnr.A2575. PMID 21799038.
  7. ↑ Puffer RC, Mustafa W, Lanzino G (September 2013). "Venous sinus stenting for idiopathic intracranial hypertension: a review of the literature". J Neurointerv Surg. 5 (5): 483–6. doi:10.1136/neurintsurg-2012-010468. PMID 22863980.

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