title: Prevention of visual loss caused by shunt failure: a potential role for optic nerve sheath fenestration. Report of three cases.
abstract: Ophthalmological problems such as papilledema, loss of visual acuity, and oculomotor palsies are common in patients with shunt malfunctions. The authors report on three patients with shunts who presented with visual loss. In each case, the diagnosis of shunt malfunction was delayed because other classic signs and symptoms of intracranial hypertension were absent. All three patients underwent optic nerve sheath fenestration (ONSF) with resultant stabilization or improvement of visual symptoms before the shunt malfunction was recognized and treated. Consideration of these cases suggests a potential protective role of ONSF for patients with shunt malfunction.
authors.affiliation: Department of Surgery, Division of Neurosurgery, University of Kentucky, Lexington, Kentucky 40536-0298, USA.
authors.forename: Christian N
authors.initials: CN
authors.lastname: Ramsey
authors.forename: Ben L
authors.initials: BL
authors.lastname: Proctor
authors.forename: Robert S
authors.initials: RS
authors.lastname: Baker
authors.forename: Thomas
authors.initials: T
authors.lastname: Pittman
mesh_terms: D000328:Adult; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D002648:Child; D019299:Decompression, Surgical / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000628:therapy; D019586:Intracranial Hypertension; D008297:Male; D009900:Optic Nerve; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology*