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26-APRIL-2010  ISLAM IZZI-DEEN AL-SAYED BAKHEET  25 YEARS  PSEUDOTUMOR CEREBRI.

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

 


 

Anamnesis

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The patient a young Sudanese citizen came to the clinic 21-April-2010 complaining of headache for 9 months, chest and neck pain followed by severe impairment of vision both eyes.

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MRI brain with MRA and MRV performed 12-July-2009, one week after visual loss was almost normal. Repeat LP done showed increased ICP with improvement of vision after such procedures. The patient was given acetazolamide, but she neglected its use.

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On examination: the patient has left oculomotor nerve paresis with severe impairment of vision both eyes.

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The patient was sent another time for MRI of the brain with contrast and MRA and MRV with complete neuroophthalmological evaluation.

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The MRI done 24-April-2010 showed normal venous structures and and fundoscopy showed secondary optic atrophy with slight elements of papilledema.

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In kidney position  lumbo-peritoneal shunt was inserted  from the right side. During that image-intensifier was used at all necessary stages of operation and the CSF flow was checked even before introduction of the distal end of the catheter to the intraperitoneal cavity.

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Routine closure of the wounds.

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Smooth postoperative recovery, with considerable improvement of vision.


Comments

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The patient  has pseudotumor cerebri of unknown etiology. The speculation that thrombosis of the midthird of the SSS was not true, because it was a misreading from the the radiologic reporter. If there was thrombosis at that time, venous congestion must have place and edema with infarction of the brain must have a place. Repeat MRV of the brain was free.

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The patient is young obese woman, which is the usual case with pseudotumor cerebri.

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For more information about pseudotumor cerebri, please click here!


Secondary optic atrophy due to neglected pseudotumor cerebri


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Notice: Not all operative activities can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also escaped from the plan .

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