The Use of Endoscopic Third Ventriculostomy as Treatment for Idiopathic Intracranial Hypertension: Case Report and a Review of Previously Reported Cases.

Abstract

Idiopathic intracranial hypertension (IIH), or pseudotumor cerebri, is a rare disorder marked by an increase of cerebrospinal fluid pressure that may cause severe headaches, papilledema, vision loss, and other symptoms. IIH is typically treated with shunts, but shunts are prone to malfunction and infection, resulting in many patients experiencing recurrent headaches after treatment. A 41-year-old woman with IIH presented with a history of severe headaches and seizures with documented elevated intracranial pressure (opening pressure 250 mm H₂O). After failure of several medical treatments, the patient was offered surgery for symptomatic relief. Given the patient's ventricular anatomy and preference, IIH was treated with endoscopic third ventriculostomy rather than a conventional shunt. Reported resolution of the patient's headaches and improved quality of life following the procedure indicated that endoscopic third ventriculostomy can be used to treat IIH if ventricles are not completely slitlike. Additionally, we present a review of all previously reported cases in which endoscopic third ventriculostomy was used for the treatment of IIH.