psuedotumor cerebri

My wife was diagnosed with Pseudo tumor in early 1990's and had optic nerve docompression surgery. This was done at Kellogg eye center in Ann Arbor Michigan by Dr Trobe. (Nuero-optamologist).  For the last 10 years she has had a "swishing" in her ear. When it is really going, I can put my ear up to hers and hear it also.  She has had several spinal taps to check and release the spinal fluid pressure which is very high.  She is currently taking 1200mg of Acetazolamide which lessons the noise.  They have mentioned to her about putting in a shunt but she is very reluctant to do this.  Any suggestions or direction would be greatly appriciated.

[John C Hagan III, MD, FACS, FAAO]

Optic nerve decompression surgery makes a hole in the dura mater lining around the optic nerve to shunt cerebro-spinal fluid  into the orbit behind the eye. It's a low pressure system and shouldn't create a should loud enough to be heard.

When one hears noises in the head or ear the concern is there is a leak (fistuala) from a high pressure system (like the arterial blood vessels) into a low pressure system (like the veins or cavernous sinus of the head).

I would suggest you discuss this again with Dr. Trobe, the neuro-ophthalmologist. He may want her to have a MRI/MRA or to see a neurologist.

JCH III MD Eye Physician & Surgeon