Indication for emergent gastric bypass in a patient with severe idiopathic intracranial hypertension: case report and review of the literature

Soto, Flavia; Antozzi, Priscila; Szomstein, Samuel; Cho, Ming Young; Zundel, Nathan; Locatelli, Eduardo; Rosenthal, Raúl J.

doi:10.1016/j.soard.2005.06.004

Cited by 11 publications

(11 citation statements)

References 23 publications

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“…All of these patients had complete demographic data. 3,11,24,25,29,30,32,42,[46][47][48] One patient was male, 25 and the remaining 61 (98%) were female. The average age was 30 years, excluding the case series reported by Michaelides et al, 29 which only reported the median age.…”

Section: Resultsmentioning

confidence: 99%

“…Results of preoperative funduscopy were reported for 58 patients, 3,11,24,25,29,30,32,42,[46][47][48] and papilledema was documented in 42 (72%) in that subgroup. Visual field examination findings were reported for 39 patients, 3,11,24,25,30,32,42,47,48 with 25 (64%) in that subgroup experiencing preoperative deficits. Visual acuity testing was reported in 10 patients, 3,25,30,47 and 2 (20%) had decreased acuity.…”

Section: Resultsmentioning

confidence: 99%

“…The BMIs were recorded or calculated pre-and postoperatively in 21 patients. 11,25,29,30,42 The postoperative BMI decrease ranged from 8.9 kg/m 2 at 3 Postoperative clinical history was recorded for 61 patients; 56 (92%) had complete resolution or significant improvement of their symptoms. Of the 5 reported patients with IIH who failed to improve with bariatric surgery, 3 were considered to have pulsatile tinnitus as their primary symptom, and this failed to resolve despite each of the patients losing at least 23 kg of body weight.…”

Section: Resultsmentioning

confidence: 99%

“…11 The remaining 10 had varying degrees of incomplete data. 3,24,25,29,30,32,42,[46][47][48] If BMI was not specifically reported, it was calculated based on height/weight data when available. In papers in which multiple follow-up periods were reported, the shortest interval with the most complete data was chosen to be included.…”

Section: Methodsmentioning

confidence: 99%

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Bariatric surgery for the treatment of idiopathic intracranial hypertension

Fridley¹,

Foroozan

Sherman

et al. 2011

JNS

127

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Bariatric surgery for the treatment of idiopathic intracranial hypertension

Fridley¹,

Foroozan

Sherman

et al. 2011

JNS

127

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“…Complete resolution of PC was observed at the one-year reevaluation. Soto et al 18 described the case of a 30-year-old woman who presented complete resolution of headache, visual impairment and dizziness three months after undergoing laparoscopic RYGB. Levin et al 11 reported the case of a 29-year-old obese woman with PC who presented dramatic improvement of headache four months after laparoscopic RYGB, and maintained this improvement one year after surgery.…”

Section: Case Reportmentioning

confidence: 99%

Bariatric surgery as a treatment for pseudotumor cerebri: case study and narrative review of the literature

et al. 2017

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CONTEXT: Pseudotumor cerebri occurs when there is an increase in intracranial pressure without an underlying cause, usually leading to loss of vision. It is most commonly observed in obese women of childbearing age. CASE REPORT: A 46-year-old woman presented at our service with idiopathic intracranial hypertension that had been diagnosed two years earlier, which had led to chronic refractory headache and an estimated 30% loss of visual acuity, associated with bilateral papilledema. She presented partial improvement of the headache with acetazolamide, but the visual loss persisted. Her intracranial pressure was 34 cmH 2 O. She presented a body mass index of 39.5 kg/m 2 , also associated with high blood pressure. Computed tomography of the cranium with endovenous contrast did not show any abnormalities. She underwent Roux-en-Y gastric bypass with uneventful postoperative evolution. One month following surgery, she presented a 24% excess weight loss. An ophthalmological examination revealed absence of visual loss and remission of the papilledema. There were no new episodes of headache following the surgery. There was also complete resolution of high blood pressure. The intracranial pressure decreased to 24 cmH 2 O, six months after the surgery. CONCLUSION: Although the condition is usually associated with obesity, there are few reports of bariatric surgery among individuals with pseudotumor cerebri. In cases studied previously, there was high prevalence of resolution or improvement of the disease following bariatric surgery. There is no consensus regarding which technique is preferable. Thus, further research is necessary in order to establish a specific algorithm. RESUMOCONTEXTO: O pseudotumor cerebri ocorre quando há aumento na pressão intracraniana sem causa subjacente, comumente levando a perda visual. É mais comum em mulheres obesas em idade fértil. RELATO DE CASO: Mulher de 46 anos, foi admitida com hipertensão intracraniana idiopática diagnosticada há dois anos, que levou a cefaleia refratária crônica e perda estimada de 30% da acuidade visual, associada a papiledema bilateral. Apresentou melhora parcial da cefaleia com acetazolamida, mas a perda visual persistiu. A pressão intracraniana era de 34 cmH 2 O. Apresentava índice de massa corpórea de 39,5 kg/m 2 , associado a hipertensão arterial. Tomografia computadorizada com contraste endovenoso de crânio não apresentou anormalidades. Foi submetida ao bypass gástrico em Y de Roux, com evolução pós-operatória sem intercorrências. Um mês após a cirurgia, apresentou perda de peso em excesso de 24%. Um exame oftalmológico demonstrou ausência de perda visual e remissão do papiledema; não houve novos episódios de cefaleia após a cirurgia. Houve também resolução completa da hipertensão arterial. A pressão intracraniana caiu para 24 cmH 2 O após seis meses da cirurgia. CONCLUSÃO: Embora a condição seja usualmente associada à obesidade, há escassos relatos de cirurgia bariátrica em indivíduos com pseudotumor cerebri. Nos casos previamente estudados, há alta pre...

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