• Badih J Daou, Ahmad Sweid, Joshua H Weinberg, Robert M Starke, Robert C Sergott, Allison S Doermann, Julie Hauge, Mario Zanaty, Nohra Chalouhi, Reid Gooch, Nabeel Herial, Hekmat Zarzour, Pascal Jabbour, Robert H Rosenwasser, and Stavropoula Tjoumakaris.
• Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
• World Neurosurg. 2020 Oct 1; 142: e73-e80.

BackgroundVisual dysfunction and headache are major symptoms in patients with idiopathic intracranial hypertension (IIH). We aimed to evaluate the improvement of these symptoms in patients who underwent ventriculoperitoneal (VPS) and lumboperitoneal (LPS) shunting.MethodsElectronic medical records were reviewed to identify baseline and treatment characteristics for patients diagnosed with IIH over 10 years. Visual outcomes and headache were evaluated at the latest follow-up post shunting.ResultsWe included 163 patients with a mean age of 32.6 years. Most patients (74.2%) underwent VPS versus 25.8% of patients who received LPS. After a mean follow-up duration of 35 months, there was a 58.3% decrease in patients reporting headache (P = 0.006), an 87.7% decrease in papilledema (P = 0.1), a 100% resolution of diplopia with VPS or LPS, and an 88.5% decrease in transient visual obscurations (P = 1). In the worse eye, improved visual acuity (VA) occurred in 53.7% of eyes (P = 1), was stable in 16.4%, and worsened in 29.8%. The mean LogMAR VA was improved by 0.06 LogMAR (20/68) in the worse eye (P = 0.97) and 0.08 LogMAR (20/31) in the better eye (P = 0.7). The visual function that impairs daily activity was decreased by 55.4% (P = 0.08). Patients shunted within 1 month of presentation had a significantly higher rate of headache (P = 0.04) and VA improvement (P < 0.001).ConclusionsVPS and LPS are effective in improving visual symptoms and headache in patients with IIH.Copyright © 2020 Elsevier Inc. All rights reserved.

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