Journal of the Korean Ophthalmological Society 1998;39(4):805-812.
Published online April 1, 1998.
Optic Nerve Sheath Penetration Surgery in Pseudotumor Cerebri.
In Taek Kim, Youl Jae Choi
Department of Ophthalmology, School of Medicine, Kyungpook National University, Taegu, Korea.
시력저하를 동반한 가뇌종양에서 시신경초감압술
김인택(In Taek Kim),최율제(Youl Jae Choi)
Abstract
Chronic papilledema secondary to pseudotumor cerebri is potentially blinding if left untreated. We performed optic nerve sheath penetration in a 35-year-old woman with pseudotumor cerebri whose visual function worsened before optic nerve sheath penetration despite medical treatment. The diagnosis of pseudotumor cerebri was made by documenting elevated CSF pressure associated with papilledema in the department of neurology. The patient had normal CSF cytologic and chemistry studies, and normal MRI finding. The patient presented with decreased visual acuity and visual field loss despite maximum medical therapy. Before the treatment with optic nerve sheath penetration, she received acetazolamide and corticosteroids. The patient experienced sustained improvement of visual acuity and visual fields in the operated eye and the fellow unoperated eye following surgery. The patient demonstrated bilateral visual improvement after unilateral surgery. There were neither intraoperative nor postoperative complications. When surgical treatment of pseudotumor cerebri becomes necessary, we advocate optic nerve sheath decompression as a preferred treatment.
Key Words: Optic nerve sheath penetration;Papilledema;Pseudotumor cerebri


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