Permanent Visual Impairment in Childhood Pseudotumor Cerebri

Visual failure without headache in idiopathic intracranial hypertension

“…Lessell first reported a paediatric series with permanent visual impairment following IIH. 9 Baker et al reviewed the literature in 1989 11 and found six paediatric studies (seven publications) 6 7 12-16 before 1985 that reported a total of 185 patients and described visual loss in only four patients (2%). Two patient series 8 10 after 1985 reported a total of 14/60 patients (23%) with visual impairment.…”

Pseudotumor Cerebri: Categorical Disease or Spectrum of Disease

“…This designation should be avoided, however, because the condition may be associated with severe debilitating visual loss in as many as 25% of patients [18,19], and therefore it is not always "benign". Instead, experts today advocate the use of the more accurate term "idiopathic intracranial hypertension".…”

Neuro-Ophthalmic Emergencies for the Neurologist

“…LPS is a rapidly effective means for lowering ICP. Burgett et al 123 reported the effects of LPS on visual status in 30 patients with IIH. LPS brought resolution of severe papilledema in 24 of 25 eyes (96%) and improved visual function in 19 of 28 eyes (68%) with no eyes demonstrating worsening of the visual field.…”

“…The main drawback of LPS, however, is a high rate of shunt malfunction in some patients necessitating multiple revisions. [123][124][125] Presenting the data on LPS as an average shunt revision rate (about 5 revisions per patient) is somewhat misleading insofar as 50% of patients are adequately managed with a single shunt procedure whereas a subgroup of patients seems to be particularly prone to shunt failure, requiring multiple revisions. 123 More marked obesity may predispose to such shunt intolerance; however, this clinical impression has not been confirmed with data.…”

“…[123][124][125] Presenting the data on LPS as an average shunt revision rate (about 5 revisions per patient) is somewhat misleading insofar as 50% of patients are adequately managed with a single shunt procedure whereas a subgroup of patients seems to be particularly prone to shunt failure, requiring multiple revisions. 123 More marked obesity may predispose to such shunt intolerance; however, this clinical impression has not been confirmed with data. Other complications of LPS include shunt infection, pleural effusion, acquired Chiari malformation, arachnoiditis, sciatica, peritonitis, catheter migration, and viscous perforation, but fortunately these complications are uncommon.…”