title: Posterior Reversible Encephalopathy Syndrome and Subarachnoid Hemorrhage After Lumboperitoneal Shunt for Fulminant Idiopathic Intracranial Hypertension.
abstract: A 33-year-old woman presented with severe visual loss from fulminant idiopathic intracranial hypertension. Her lumbar puncture opening pressure was 97 cm H2O. Soon after lumboperitoneal shunt surgery, she had a generalized tonic-clonic seizure. Magnetic resonance imaging demonstrated frontal subarachnoid hemorrhage (SAH) and neuroimaging findings consistent with posterior reversible encephalopathy syndrome (PRES). We hypothesize that an abrupt drop in intracranial pressure after lumboperitoneal shunting led to maladjustment of cerebral vascular autoregulation, which caused SAH and PRES.
authors.affiliation: Departments of Neuroscience (AF, ML, US, PK); Diagnostic Imaging (RVC), Monash Health, Melbourne, Australia; Department of Medicine (RVC, US), Monash University, Melbourne, Australia; and Department of Neurosurgery (MG), Monash Health, Melbourne, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Fok
authors.forename: Ronil V
authors.initials: RV
authors.lastname: Chandra
authors.forename: Matthew
authors.initials: M
authors.lastname: Gutman
authors.forename: Matthew
authors.initials: M
authors.lastname: Ligtermoet
authors.forename: Udaya
authors.initials: U
authors.lastname: Seneviratne
authors.forename: Peter
authors.initials: P
authors.lastname: Kempster
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007427:Intracranial Pressure; D008279:Magnetic Resonance Imaging; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis / Q000209:etiology*; D011183:Postoperative Complications; D011559:Pseudotumor Cerebri / Q000175:diagnosis / Q000601:surgery*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*