[A rare cause of peracute vision loss: pseudotumor cerebri. Case report of course with recurrence after decompression of the optic nerve].
In primary pseudotumor cerebri (PTC) intracranial pressure is elevated by so far unknown mechanisms. There is a wide range of clinical courses. Therapy is controversial. We present a case of PTC with acute visual loss. After optic nerve sheath decompression a relapse occurred. A 30-year old female patient experienced visual loss within 48 h accompanied by headache and slight neck stiffness. Visual acuity was 1/50 in the right eye; in the left eye just hand movements and light were perceived. Fundoscopy revealed a 9 dptr. prominent optic disc bilaterally. After optic nerve sheath decompression (ONSD) she improved, but underwent a relapse after 3 months. Twenty-four-hour measurement of intracranial pressure revealed elevated values. As a consequence ventriculo-peritoneal shunting was performed, leading to prominent improvement. Primary PTC can cause acute visual loss. If conservative treatment fails, different surgical procedures should be considered.
Neurologische Klinik und Poliklinik, Universität Erlangen-Nürnberg.
J G
JG
Heckmann
H
H
Stefan
M J
MJ
Groh
M
M
Winterholler
B
B
Neundörfer
D000328:Adult; D001766:Blindness / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D011559:Pseudotumor Cerebri / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D017287:Ventriculoperitoneal Shunt
Seltene Ursache eines perakuten Visusverlustes: Pseudotumor cerebri. Fallbericht über Verlauf mit Rezidiv nach Dekompression des N. optikus.