Re: Pseudotumor cerebri

Posted By Jerry Sudduth on August 17, 1998 at 21:22:35:

In Reply to: Re: Pseudotumor cerebri posted by CCF NSG MD /gsh on August 05, 1998 at 16:33:55:






My 26 year old daughter has Pseudotumor cerebri. She went in to have
her eyes checked since she was losing her vision for a second or two.
She immediately was sent to the hospital and they put a shunt inside of
her head to relieve the pressure. This seemed to work for approximately
one year.  She then started getting severe headaches, nausea and
vomiting. The pressure was again rising. The doctor was concerned with
her loosing her eye sight due to the pressure. She then had holes drilled in
the optic nerve casings behind each eye to relieve the pressure. This seemed to be successful but the final check up showed the pressure building up again. The surgeon then went in and changed the valve on the shunt.
The pressure is building up again and Mindy is scheduled to have another
spinal tap this Thursday and then have a shunt placed on her spine next
Tuesday. I am looking for any suggestions on what steps to take next.
It is my understanding that the shunt on the spinal system does not normally
work.   HELP!!!!
Thank You,
Jerry Sudduth
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Dear Jerry,
Pseudotumor cerebri is a condition typically seen in overweight women in their
20's or 30's.  It usually presents as headaches or visual difficulties.  Patients
are usually treated with a shunt, either in the head or in the spine.  In
refractory cases, surgery to decompress the optic nerve may be considered.
If left untreated, patients can lose vision.
Shunts can be difficult to manage at times.  They can become kinked, clogged
and infected.  Any of these can cause them to stop working and fail, resulting
in a recurrence of symptoms.  Lumbo-peritoneal shunts fail a little more often
than ventriculo-peritoneal shunts.  Recurrent shunt failures can signal an
indolent infection in the system, which is possible here.  Some 'bugs' are
weaker and do not present with fevers and redness.  If your daughter has had
numerous failures, be sure they have checked for infectious causes.  
Check with your daughter's surgeon and see if he doesn't agree.
Good luck.
Mindy had the Lumbo-peritioneal shunt on 8/11/98.  She was sent  home
on 8/12.  All seemed to be going ok until 8/14. She became ill again and
was taken to the hospital. She was given some medication for her pain
and her vomiting. She went home on the evening of the 14th. The
following morning her husband called the doctor because she was getting
worse and he suggested they go to the hospital. They admitted her on
Saturday the 15th.  Today, Monday the 17th, she was told that they
believe the problem is with her system rejecting the shunt. That this happens and they are giving her medicine to fight the rejection. If the body continues to reject the shunt, what alternatives do we have?
Thank You,
Jerry Sudduth