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Abstract

BACKGROUND: First line of management of benign intracranial hypertension is through conservative approach by medications and weight loss program and is reported to have successful effects, however failure to or no response to conservative treatment leads to surgical intervention consisting of optic nerve sheath fenestration, endoscopic decompression of optic nerve, venous sinus stenting and CSF diversion techniques (Ventriculoperitoneal or lumbar-peritoneal shunt).
OBJECTIVE: To evaluate the clinical outcomes of lumbo-peritoneal shunt in terms of resolution of headaches and visual symptoms especially papilledema along with the possible complications.
MATERIAL AND METHODS: A retrospective observational study was conducted from the records of three years (2019 to 2022 with 1.5 years follow up). Clinical records were analyzed for including the patients with non-probability convenience sampling. Patients were operated on through lumbo-peritoneal shunt. Subjective improvement in headache and resolution of papilledema through fundoscopic pictures along with visual acuity assessed through Snellen chart were the main outcomes assessed at follow up. SPSS version 26 was used to analyze the data.
RESULTS: A total of 157 cases were operated for benign intracranial hypertension out of which 71 (45%) patients underwent lumbo-peritoneal shunt. Majority of the patients were females 58(82%) while 13(18%) were males.The most common clinical feature reported by majority of the participants was headache 63(89%) while all the patients suffered from papilledema 71(100%). Among these, 61(86%) demonstrated subjective improvements in headaches while 65(91%) patients had resolution to fundoscopic picture.
CONCLUSION: This study concluded that Lumbo-peritoneal shunt is an effective and safe surgical procedure in improving symptoms associated with benign intracranial hypertension such as headache and papilledema, however the procedure is also associated with complications such as infection and revision surgeries.
KEYWORDS: Benign intracranial hypertension, lumbo-peritoneal shunt, lumbar peritoneal shunt, papilledema, pseudotumor cerebri, idiopathic intracranial hypertension.