Sudden Loss of Vision as a Result of Idiopathic Intracranial Hypertension: A Case Report
Leniel Laud Rodríguez MD1*, Greysis Hernandez Roman MD1, Yoel Socorro Izquierdo MD1, Ana E. Rodríguez Gonzalez MSc2, Alberto L Carrillo Comas MD1 and Enrique Sierra Benites MD1
1Department of Neurosurgery, Commander Fautino Pérez Hospital Universitary Hospital, Cuba
2Department of Psychology, Provincial Pregnant Home of Matanzas, Cuba
*Corresponding Author: Leniel Laud Rodríguez, MD, Department of Neurosurgery, Commander Fautino Pérez Hospital Universitary Hospital, Cuba.
Received: March 04, 2022 Published: March 22, 2022
Abstract
Introduction: Pseudotumor cerebri syndrome is a condition characterized by an increase in intracranial pressure without demonstrable cause, without evidence of ventricular dilatation and with papilledema.
Case Report: 37-year-old male patient with a history of anemia without known cause and Idiopathic Intracranial Hypertension for 2 years, which was treated conservatively. A year and a half later, he returned to the clinic again because he reported an abrupt loss of vision in only 3 days without headache. Complementary studies were performed and showed an increase in intracranial pressure and an increase in the transverse diameter of both optic nerves in imaging studies, so it was decided to perform emergency surgical treatment.
Discussion: Microsurgical fenestration of the optic nerve sheath by means of a medial or lateral transscleral orbitotomy and lumbo-peritoneal CSF derivation were the techniques proposed to solve the increase in intracranial pressure. Lumboperitoneal shunting was finally decided as definitive treatment due to the bilateral atrophy of the papilla presented by this patient. Seven days after surgery, MRI studies of the orbit show normal recovery of the transverse diameter of the optic nerves. Although the patient does not improve the visual loss, the progression to amaurosis is stopped.
Conclusions: Ideopathic intracranial hypertension is a disease that although its highest incidence is in the female and obese population, it can occur in any patient. The follow-up of asymptomatic patients in neuroophthalmology consultation prevents residiva, identifying papilledema from its incipient form, which favors treatment in its early stages and avoids its progression to optic atrophy.
Keywords: cerebral pseudotumor, idiopathic intracranial hypertension, papilledema, optic nerve sheath fenestrations, lumboperitoneal shunt.
Citation: Rodríguez LL, Roman GH, Izquierdo YS, Gonzalez AER, Comas ALC, Benites ES. “Sudden Loss of Vision as a Result of Idiopathic Intracranial Hypertension: A Case Report”. SVOA Neurology 3:2 (2022) Pages 68-71.
