TY - JOUR
A1 - Johnson, Jeremiah
A1 - Elhammady, Mohamed
A1 - Theodotou, Christian
A1 - Ashour, Ramsey
A1 - Aziz-Sultan, Mohammad
T1 - Cervical puncture and perimedullary cistern shunt placement for idiopathic intracranial hypertension: An alternative to lumbar cistern or cerebral ventricular catheter placement a report of two cases
Y1 - 1998/7/1
JF - Indian Journal of Ophthalmology
JO - Indian J Ophthalmol
SP - 153
EP - 157
VL - 46
IS - 3
UR - https://journals.lww.com/ijo/pages/default.aspx/article.asp?issn=0301-4738;year=1998;volume=46;issue=3;spage=153;epage=157;aulast=John
DO - 10.4103/1793-5482.142735
N2 - Objective: Idiopathic intracranial hypertension (IIH) is a syndrome characterized by increased intracranial pressure (ICP) in the absence of an identifiable cause, and if untreated, can result in permanent vision loss. In symptomatic IIH patients, cerebrospinal fluid (CSF) diversion can lower ICP and protect vision; however, currently used CSF diversion systems are prone to malfunction in this population.
Materials and Methods: In two IIH patients with histories of numerous prior shunt revisions that presented with proximal ventriculoperitoneal shunt malfunction, ICP reduction was achieved by an alternative surgical cerebrospinal fluid (CSF) diversion technique: Fluoroscopically guided, percutaneous placement of a catheter in the premedullary cistern and subsequent connection to the valve and distal shunt system.
Results: Postoperatively, both patients' papilledema resolved, headaches improved, and the shunts were working well at 3-month follow-up. At 1-year follow-up, one patient was well without papilledema or symptom recurrence, and the second patient had the shunt system removed by an outside surgeon.
Conclusion: This technique may hold promise as an alternative shunting strategy in IIH patients with numerous proximal shunt failures or who are poor candidates for ventricular and lumbar shunts.
ER -