CSF Shunting Procedures in Idiopathic Intracranial Hypertension (IIH)

A 48 year old obese female, presented with worsening of her longstanding holo-cephalic headaches, nausea and transient visual obscurations. Her physical examination on two different occasions revealed progressive worsening of her bilateral papilledema. Her MRI revealed significant narrowing of the transverse sinuses bilaterally without evidence of venous sinus thrombosis. A lumbar puncture revealed an opening pressure of 31 cm of water. A trial of acetazolamide was not successful. The patient underwent insertion of a ventriculo-peritoneal shunt. Post-operatively, her headaches and visual signs and symptoms improved significantly.