Refractory Pseudotumour Cerebri in a Pediatric Case

Abstract

Pseudotumour cerebri (PTC) is traditionally defined as increased intracranial pressure (ICP) >200 mmH(2)O with non-focal neurological findings, except the sixth-nerve palsy, and normal cerebrospinal fluid (CSF) composition without brain pathology or evidence of venous thrombosis. A 6-years-old girl was referred to our clinic for blurred vision in her left eye and a progressive headache. Her history was positive for a progressive vision loss in the left eye. Both optic disks were blurred and swollen. The opening pressure of CSF was 310 mm/ H2O. Despite the repeated lumbar punctures (LP) and medical treatment, the patient had to undergo the optic nerve sheath fenestration. A consequent shunt procedure had to be performed due to a persistently high CSF level. In this report, we emphasize that if surgical procedures can be applied earlier in refractory PTC cases, better results of visual improvement may be observed. In this report, we emphasize that early surgical treatment in refractory PTC cases results in better visual improvement.