Endoscopic Optic Nerve Decompression for Idiopathic Intracranial Hypertension in Two Cases: Case Report

Abstract

Pseudotumor cerebri is a syndrome with headaches and visual loss that sometimes cannot be treated with medication. In spite of medical treatment, the clinical course in some patients can approach extreme dysfunction with severe impairment in visual field and acuity as well as incapacitating headache. Patients with progressive or persistent symptoms require surgical treatment and decompression of the optic nerve is the preferred surgical procedure. We report on two cases of bilateral decompression of the optic nerves performed through an endonasal endoscopic approach.

Key words

idiopathic intracranial hypertension - pseudotumor cerebri - optic nerve decompression - endoscope

References

• 1 Binder DK, Horton JC, Lawton MT, Macdermott MW. Idıopathic intracranial hypertension.  Neurosurgery. 2004;  54 538-552
• 2 Dandy WE. Intracranial pressure without brain tumors: Diagnosis and treatment.  Ann Surg. 1937;  106 492-513 , [abstract]
• 3 Digre KB, Corbett JJ. Idiopathic intracranial hypertension (pseudotumor cerebri): A reappraisal.  The Neurologist. 2001;  7 2-67
• 4 Greer M. Mangement of benign intracranial hypertension (pseudotumor cerebri).  Clin Neurosurgery. 1968;  15 161-174
• 5 Kessler LA, Novelli PM, Reigel DH. Surgical treatment of benign intracranial hypertension - subtemporal decompression revisited.  Surg Neurol. 1998;  50 73-76
• 6 Brourman ND, Spoor TC, Ramocki JM. Optic nerve sheath decompression for pseudotumor cerebri.  Arch Ophthalmology. 1988;  106 1378-1383
• 7 Corbett JJ, Nerad JA, Tse DT, Anderson RL. Results of optic nerve sheath fenestration for pseudotumor cerebri.  The lateral orbitotomy approach: Arch Ophthalmology. 1988;  106 1391-1397
• 8 Kelman SE, Heaps R, Wolf A, Elman MJ. Optic nerve decompression surgery improves visual function in patients with pseudotumor cerebri.  Neurosurgery. 1992;  30 391-395
• 9 Sergott RC, Savino PJ, Bosley TM. Modified optic nerve sheath decompression provides long-term visual improvement for pseudoumor cerebri.  Arch Ophthalmology. 1988;  106 1384-1390
• 10 Burgett RA, Purvin VA, Kawasaki A. Lumboperitoneal shunting for pseudotumor cerebri.  Neurology. 1997;  49 734-739
• 11 Eggenberger E, Miller NR, Vitale S. Lumbperitoneal shunt for the treatment of pseudotumor cerebri.  Neurology. 1996;  46 1524-1530
• 12 Johnston I, Besser M, Morgan MK. Cerebrospinal fluid diversion in the treatment of benign intracranial hypertension.  J Neurosurgery. 1988;  69 195-202
• 13 Spoor TC, MacHenry JG. Long term effectiveness of optic nerve sheath decompression for pseudotumor cerebri.  Ophthalmology. 1993;  111 632-635
• 14 Gupta AK, Rajini Ganth MG, Gupta A. Modified endoscopic optic nerve decompression in idiopathic intracranial hypertension.  J Laryngol Otol. 2003;  117 501-502
• 15 Patrocinio JA, Patrocinio LG, Junior FB, daCunha AR. Endoscopic decompression of the optic nerve in pseudotumor cerebri.  Auris Nasus Larynx. 2005;  32 199-203
• 16 Greer M. Benign intracranial hypertension. In:Vinken PJ, Bruyn GW, eds. Handbook of clinical neurology. Amsterdam, North Holland 1974: 150-166
• 17 Kelman SE, Sergott RC, Cioffi GA. Modified optic nerve decompression in patients with functioninig lumboperitoneal shunts and progressive visual loss.  Ophthalmology. 1991;  98 1449-1453
• 18 Sergott RC, Savino PJ, Bosley TM. Optic nerve sheath decompression: A clinical review and proposed pathophysiologic mechanisms.  Aust N Z J Ophthalmol. 1990;  18 365-373
• 19 Maus M, Sergott RC. Optic nerve sheath decompression: A review.  Int Ophthalmol Clin. 1992;  32 179-196
• 20 Banta JT, Farris BK. Pseudotumor cerebri and optic nerve sheath decompression.  Ophthalmology. 2000;  107 1907-1912
• 21 Spoor TC, MacHenry JG, Shin DH. Optic nerve sheath decompression with adjunctive mitomycin and Molteno device implantation.  Arch Ophthalmol. 1994;  112 25-26
• 22 Mauriello  Jr  JA, Shaderowfsky BA, Gizzi M. Management of visual loss after optic sheath decompression in patients with pseudotumor cerebri.  Ophthalmology. 1995;  102 441-445
• 23 Plotnik JL, Kosmorsky G. Operative complications of optic nerve sheath decompression.  Ophthalmology. 1993;  100 683-690
• 24 Kuppersmith RB, Alford EL, Patrinely JR, Lee AG, Parke RB, Holds JB. Combined transconjunctival/intranasal endoscopic approach to the optic canal in traumatic optic neuropathy.  Laryngoscope. 1997;  107 311-315
• 25 Luxenberger W, Stammberger H, Jebeles JA, Walch C. Endoscopic optic nerve decompression: The Graz Experience.  Laryngoscope. 1998;  108 873-882

Correspondence