uneven pupils

[keyman26]

My wife was recently diagnosed as having pseudotumor cerebri.  She presented at hospital with a terrible migraine and uneven pupils.  Her right pupil was fully dilated and unresponsive to light.
To cut a very long story short, they cleared her of tumors and bleeds etc and on performing a lumbar puncture, they determined the pressure in her spinal fluid was extremely high.
She was recommended to have a spinal shunt installed to help reduce the pressure and she agreed.  Post op, we (and the Dr's) expected things to normalise after a few days of a low pressure migraine.
Unfortunately, things haven't come right - she still can't sit up more than about 30deg without dizziness, nausea and pain to her eyes.  Her eyesight continues to worsen and often her pupils are uneven and sluggish or non responsive to light.  The drs said her eyes blown out fully was reminisent of someone in a coma!
The drs have finally agreed to perform an MRI to see if they are missing things on the CAT scan - I feel sure that they have missed something as things aren't adding up right now.
The eye dr's think its in the neuro surgeons area, and vice versa and we're the meat in the middle so to speak.
any suggestions or advice that I could pass on for investigation most welcome.

[keyman26]

We're in 2nd (or 3rd) largest hospital in the country (New Zealand), so in theory we should have access to pretty decent help.
she's making progess, but its painfully slow.  able to sit up at about 60 to 70 degrees now - but still in considerable pain from (what we think is) negative pressure in her head.
Now her right eye's pupil is normal, but the vision is very poor - probably nerve damage.  but the previously good left eye has now dilated and is very sluggishly responding to light.
fingers crossed we'll get an MRI sometime today and hopefully it'll reveal something - or even better, it'll reconfirm nothing like a tuma is present.
Thanks for your time

[Michael J Kutryb, MD]

If she is having these type of problems she should be at a major university teaching hospital hopefully.  My best advise is to try to find the best ophthalmologst teaching hospital in your area.  The problem is way to complex to get very far on this forum.   I'm not sure where you are but perhaps I can help you to find a referral center not too far.  That's may be what it's going to take, I suspect, for you to feel more comfortable with her care.
MJK MD