Lumbar peritoneal shunt in idiopathic intracranial hypertension

Abstract

Aim: Treatment options for idiopathic intracranial hypertension (IIH) are lumbar peritoneal shunt (LP), optic nerve fenestration, ventriculoperitoneal shunt and venous stenting. We report our experience of 24 cases of LP shunt. Material and Methods: All the patients had preoperative fundus examination, cerebrospinal fluid pressure estimation and examination, visual field charting, CT scan and MR venography. Postoperative fundus examination and visual field charting was done in all cases. Follow up ranged from 18 to 137 months. Results: Preoperative papilledema, headache, decreased vision, optic atrophy and diplopia were seen in 24, 24, 19, 10 and 11 patients respectively. Shunt failure, CSF leak and temporary over drainage complications in the form of headache were seen in 2, 1 and 15 cases respectively. Vision improved in 10 out of 18 patients. Only one patient, out of 9 who had only perception of light and optic atrophy preoperatively, had improved vision while all patients with vision of finger counting or better without optic atrophy improved after shunt. Conclusion: LP shunt is safe and effective in IIH. Results in terms of improvement in vision were better in good pre operatively vision group.