[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.
Heckmann
J G
JG
Neurologische Klinik und Poliklinik, Universität Erlangen-Nürnberg.
Stefan
H
H
Groh
M J
MJ
Winterholler
M
M
Neundörfer
B
B
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.