Will CSF Diversion in Patients with Idiopathic Intracranial Hypertension (IIH) Lead to Long-Lasting Shunt Dependency?

Tryggve Lundar,Bernt Johan Due-Tønnessen

doi:10.5772/intechopen.96291

Abstract

Long-term shunt dependency rates in patients treated for IIH with CSF diversion have not been established. We therefore present our experience with 5 children shunted for IIH during the years 1984–2000 with very long-time follow-up. Three out of these patients have experienced late or very late episodes of severe shunt failure during the second or third decade after initial shunt treatment. They were all boys and may not be representative for IIH patients as a whole. Three of them appear, however, to be permanently shunt dependent, indicating that long-term shunt-dependency in children treated for IIH with CSF diversion may be more common than previously expected.

Highlights

In 1937 Walter Dandy published a series of 22 patients treated surgically for intracranial hyper-tension without a tumor [1]
All children (0–19 years old) who underwent a shunt implantation for Intracranial Hypertension (IIH) during the years 1980–2000 in our institution were identified from the surgical protocols
We present our experience with these pediatric patients shunted for IIH during the years 1984 to 2000; and have long-term follow-up

Summary

Introduction

In 1937 Walter Dandy published a series of 22 patients treated surgically for intracranial hyper-tension without a tumor [1]. Among his cases treated with subtemporal decompression during a period of 10 years, there were 3 children. Later on, this condition with papilledema, headache and visual disturbances was called benign intracranial hypertension, and many of them could be managed favorably by medical treatment [2]. It soon became clear that this obscure disease is not always that benign [3]. In severe cases the term malignant pseudotumor was introduced [4]. Later on the term Idiopathic Intracranial Hypertension (IIH) was introduced [5]

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Conclusion