open access

Vol 52, No 3 (2018)
Case reports
Submitted: 2017-08-22
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Ventriculoperitoneal shunt treatment in a pregnant renal transplant recipient with idiopathic intracranial hypertension: Case report and review of the literature

Ebru Apaydın Doğan, Selen Doğan, Ethem Taner Göksu, Sibel Özkaynak, Çile Aktan, İnanç Mendilcioğlu
DOI: 10.1016/j.pjnns.2018.01.005
·
Neurol Neurochir Pol 2018;52(3):401-405.

open access

Vol 52, No 3 (2018)
Case reports
Submitted: 2017-08-22

Abstract

Idiopathic intracranial hypertension (IIH) is a relatively uncommon disorder characterised by raised intracranial pressure without an established pathogenesis. Diagnosis of IIH requires the demonstration of symptoms and signs referable only to elevated intracranial pressure; cerebrospinal fluid (CSF) opening pressure >25cm H2O measured in the lateral decubitus position; normal CSF composition; and no evidence for an underlying structural cause demonstrated by using MRI or contrast-enhanced CT scan for typical patients and MRI and MR venography for atypical patients such as man, children and those with low body mass index. We present a 38-year old primigravid renal transplant patient at 7 weeks of gestation who presented with 2 weeks of intense, throbbing, holocranial headache, nausea, vomiting, photophobia, diplopia and progressive visual loss. When medical treatment fails and/or not appropriate to use due to the reported of teratogenic risks in pregnant women, surgical interventions gain importance. In this particular patient, venticuloperitoneal shunt was chosen as the CSF diversion technique. In this case report indications, contraindications in addition to outcomes regarding headache, vision loss and the resolution of papilloedema of the present surgery options for IIH are discussed.

Abstract

Idiopathic intracranial hypertension (IIH) is a relatively uncommon disorder characterised by raised intracranial pressure without an established pathogenesis. Diagnosis of IIH requires the demonstration of symptoms and signs referable only to elevated intracranial pressure; cerebrospinal fluid (CSF) opening pressure >25cm H2O measured in the lateral decubitus position; normal CSF composition; and no evidence for an underlying structural cause demonstrated by using MRI or contrast-enhanced CT scan for typical patients and MRI and MR venography for atypical patients such as man, children and those with low body mass index. We present a 38-year old primigravid renal transplant patient at 7 weeks of gestation who presented with 2 weeks of intense, throbbing, holocranial headache, nausea, vomiting, photophobia, diplopia and progressive visual loss. When medical treatment fails and/or not appropriate to use due to the reported of teratogenic risks in pregnant women, surgical interventions gain importance. In this particular patient, venticuloperitoneal shunt was chosen as the CSF diversion technique. In this case report indications, contraindications in addition to outcomes regarding headache, vision loss and the resolution of papilloedema of the present surgery options for IIH are discussed.

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Keywords

Idiopathic intracranial hypertension, Pregnancy, Vision loss, Headache

About this article
Title

Ventriculoperitoneal shunt treatment in a pregnant renal transplant recipient with idiopathic intracranial hypertension: Case report and review of the literature

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 52, No 3 (2018)

Pages

401-405

DOI

10.1016/j.pjnns.2018.01.005

Bibliographic record

Neurol Neurochir Pol 2018;52(3):401-405.

Keywords

Idiopathic intracranial hypertension
Pregnancy
Vision loss
Headache

Authors

Ebru Apaydın Doğan
Selen Doğan
Ethem Taner Göksu
Sibel Özkaynak
Çile Aktan
İnanç Mendilcioğlu

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