J Korean Ophthalmol Soc.  1998 Apr;39(4):805-812.

Optic Nerve Sheath Penetration Surgery in Pseudotumor Cerebri

• Kim IT
• Choi YJ

Abstract

Chronic papilledema secondary to pseudotumor cerebri is potentially blinding if left untreated. We performed optic nerve sheath penetration in a 35-year-old woman with pseudotumor cerebri whose visual function worsened before optic nerve sheath penetration despite medical treatment. The diagnosis of pseudotumor cerebri was made by documenting elevated CSF pressure associated with papilledema in the department of neurology. The patient had normal CSF cytologic and chemistry studies, and normal MRI finding. The patient presented with decreased visual acuity and visual field loss despite maximum medical therapy. Before the treatment with optic nerve sheath penetration, she received acetazolamide and corticosteroids. The patient experienced sustained improvement of visual acuity and visual fields in the operated eye and the fellow unoperated eye following surgery. The patient demonstrated bilateral visual improvement after unilateral surgery. There were neither intraoperative nor postoperative complications. When surgical treatment of pseudotumor cerebri becomes necessary, we advocate optic nerve sheath decompression as a preferred treatment.

Keyword

Optic nerve sheath penetration; Papilledema; Pseudotumor cerebri

MeSH Terms

Acetazolamide
Adrenal Cortex Hormones
Adult
Chemistry
Decompression
Diagnosis
Female
Humans
Magnetic Resonance Imaging
Neurology
Optic Nerve*
Papilledema
Postoperative Complications
Pseudotumor Cerebri*
Visual Acuity
Visual Fields
Acetazolamide
Adrenal Cortex Hormones