Effect of Shunting on Visual Outcomes and Headache in Patients with Idiopathic Intracranial Hypertension

Badih J. Daou; Ahmad Sweid; Joshua H. Weinberg; Robert M. Starke; Robert C. Sergott; Allison S. Doermann; Julie Hauge; Mario Zanaty; Nohra Chalouhi; Reid Gooch; Nabeel Herial; Hekmat Zarzour; Pascal Jabbour; Robert H. Rosenwasser; Stavropoula Tjoumakaris

doi:10.1016/j.wneu.2020.05.186

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Effect of Shunting on Visual Outcomes and Headache in Patients with Idiopathic Intracranial Hypertension

Journal article

Peer reviewed

Effect of Shunting on Visual Outcomes and Headache in Patients with Idiopathic Intracranial Hypertension

Badih J. Daou, Ahmad Sweid, Joshua H. Weinberg, Robert M. Starke, Robert C. Sergott, Allison S. Doermann, Julie Hauge, Mario Zanaty, Nohra Chalouhi, Reid Gooch, …

World neurosurgery, Vol.142, pp.e73-e80

10/2020

DOI: 10.1016/j.wneu.2020.05.186

PMID: 32474095

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Abstract

Visual dysfunction and headache are major symptoms in patients with idiopathic intracranial hypertension (IIH). We aimed to evaluate the improvement of these symptoms in patients who underwent ventriculoperitoneal (VPS) and lumboperitoneal (LPS) shunting. Electronic medical records were reviewed to identify baseline and treatment characteristics for patients diagnosed with IIH over 10 years. Visual outcomes and headache were evaluated at the latest follow-up post shunting. We included 163 patients with a mean age of 32.6 years. Most patients (74.2%) underwent VPS versus 25.8% of patients who received LPS. After a mean follow-up duration of 35 months, there was a 58.3% decrease in patients reporting headache (P = 0.006), an 87.7% decrease in papilledema (P = 0.1), a 100% resolution of diplopia with VPS or LPS, and an 88.5% decrease in transient visual obscurations (P = 1). In the worse eye, improved visual acuity (VA) occurred in 53.7% of eyes (P = 1), was stable in 16.4%, and worsened in 29.8%. The mean LogMAR VA was improved by 0.06 LogMAR (20/68) in the worse eye (P = 0.97) and 0.08 LogMAR (20/31) in the better eye (P = 0.7). The visual function that impairs daily activity was decreased by 55.4% (P = 0.08). Patients shunted within 1 month of presentation had a significantly higher rate of headache (P = 0.04) and VA improvement (P < 0.001). VPS and LPS are effective in improving visual symptoms and headache in patients with IIH.

Headache

Idiopathic intracranial hypertension

Lumboperitoneal shunt

Pseudotumor cerebri

Ventriculoperitoneal shunt

Vision

Details

Title: Subtitle: Effect of Shunting on Visual Outcomes and Headache in Patients with Idiopathic Intracranial Hypertension
Creators: Badih J. Daou - University of Michigan
Ahmad Sweid - Thomas Jefferson University
Joshua H. Weinberg - Jefferson Hospital for Neuroscience
Robert M. Starke - University of Miami Hospital
Robert C. Sergott - Wills Eye Hospital
Allison S. Doermann - Jefferson Hospital for Neuroscience
Julie Hauge - University of Pennsylvania
Mario Zanaty - University of Iowa
Nohra Chalouhi - Jefferson Hospital for Neuroscience
Reid Gooch - Jefferson Hospital for Neuroscience
Nabeel Herial - Thomas Jefferson University
Hekmat Zarzour - Jefferson Hospital for Neuroscience
Pascal Jabbour - Jefferson Hospital for Neuroscience
Robert H. Rosenwasser - Jefferson Hospital for Neuroscience
Stavropoula Tjoumakaris - Jefferson Hospital for Neuroscience
Resource Type: Journal article
Publication Details: World neurosurgery, Vol.142, pp.e73-e80
DOI: 10.1016/j.wneu.2020.05.186
PMID: 32474095
NLM abbreviation: World Neurosurg
ISSN: 1878-8750
eISSN: 1878-8769
Publisher: Elsevier Inc
Language: English
Date published: 10/2020
Academic Unit: Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984527181702771

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