A Case of Idiopathic Intracranial Hypertension Treated with Optic? Nerve Sheath Fenestration

J Korean Neurol Assoc > Volume 12(4); 1994 > Article

Journal of the Korean Neurological Association 1994;12(4): 770-775.

시신경초 유창술로 치험한 원발성 두개내 고혈압 1예

임성룡, 김형준,예종수,장지훈,허경,조효근

인제대학교 신경과.

A Case of Idiopathic Intracranial Hypertension Treated with Optic? Nerve Sheath Fenestration

Sung Ryoung Lim, M.D., Hyeong Jun Kim, M.D., Jong Su Ye, M.D., Ji Hun Jang, M.D., Kyoung Heo, M.D., Hyo Kun Cho, M.D.

Department of Neurology, Pusan Paik Hospital, Inje University College of Medicine, Pusan, Korea

Abstract

Idiopathic intracranial hypertension, a syndrome of obscure origin, occurs particularly in fat adolescent girls and young women. The usual symptoms are headache, blurred vision, a vague dizziness, horizontal diplopia and transient visual obscurations etc., and ophthalmoscopic examination reveals papillederma, due to increased ICP. Visual field testing usually shows slight peripheral constrictions with enlargement of the blind sports. CSF pressure is elevated in the range of 250 to 450 mm of water. Radiological or the other laboratory tests show no specific abnormalities. Treatment for idiopathic intracranial hypertension is focused on early detection and prevention of vision loss, the only permanent morbidity. Many different modes of medical treatment, including weight reduction, repeated lumber puncture, corticosteroids, diuretics, glycerol or carbonic anhydrase inhibitors, have successfully been tried up to 90% of the patients. In the remaining patients, particularly in those with measurable impairment of vision that does not respond to conventinal medical therapies, surgical procedure should be considered. We report a case of idiopathic intracranial hypertension successfully treated with optic nerve sheath fenestration.