The patient came to the clinic 20-December-2021 complaining of episodes of blindness for 1 year with exacerbation last 6 months. MRI brain done 20-May-2021 not complete and not informative. Seen by ophthalmologists and papilloedema was established. Acetazolamide did not help, instead caused multiple side effects.

On examination, the patient complaining of headache with photophobia and episodes of blurred vision, more the left eye. She has neck pain and weak right upper limb with hypalgesia right side of the face and right upper limb.

The patient was sent for investigations and fundus photography showed papilloedema both optic nerves more the left with scattered scatomas both fields, more dense at the left side. MRI of the brain done the same day showing angry optic nerves with CSF around them and partially empty sella turcica. There is also bulging disci C3-4, 5-6 and C6-7.

In left kidney position, using programmable Medtronic lumbo-peritoneal shunt system, the Touhy needle was inserted between L3-4 and the proximal part of the shunt was inserted 20 cm above the dural entrance intradurally . Separate incision was created above the left lower rib and the distal intraperitoneal part was inserted. The valve was connected and checked for patency. It was configured to be with medium pressure parameters.  Routine closure of the wounds. Smooth postoperative recovery. She was sent to the ward.

Too early now, but the patient claim that vision improved after surgery.

The patient has pseudotumor cerebri and when conservative treatment fails, the LPShunt is advisable.