Vertical Sleeve Gastrectomy and Psuedotumor Cerebri

[roxmary]

So today I saw a bariatric surgeon and discussed having the VSG, I had already done all my research and was all set to sign the paperwork and get things started until he told me he had a patient that went blind.  I have a history of Psuedotumor Cerebri {PTC} and haven't had an episode or had to be treated for it in about 5 years.  I mentioned that to the surgeon and he advised me that with PTC as a history I have a chance of becoming blind post operatively.  He stated that in the 10 years he's been doing this he had one case that it actually happened. That still  really scared me!!!! I have been online for hours but can't find anything confirming that my chance of blindness.  Everything I have found online states that gastric surgery is used as treatment for  PTC.  This is the only thing that held me back from scheduling everything today, I was already aware of all the other risks. Can anyone give me more information or help me with this????

[Dr. Kokil Mathur]

Hi!
Yes, hearing that you can go blind can be scary. Since you have benign intracranial hypertension (BIH) or pseudotumor cerebri (PTC), naturally you are more concerned. Vertical Sleeve Gastrectomy is not a treatment for PTC. It could be taken up in severely obese with PTC to reduce the chances of relapse and for better working of the shunt.

Blindness after Sleeve operation was an unfortunate side effect. As you have already researched this operation and its risks, you know it can cause sepsis and deep vein thrombosis. In either case a clot can form in blood vessel and travel in the blood and get lodged in any blood vessel causing pulmonary embolism, stroke, blindness, heart attack etc. This could have happened in the patient’s case your surgeon was talking about. Definitely having PTC is an additional disadvantage as the anesthetist will have to work at keeping normal CSF pressure and avoid too high and too low CSF pressures. Please re-discuss your treatment options in view of this.

I sincerely hope you will find this information useful in your journey towards better health.
Good Luck and take care!

[roxmary]

I couldn't find anything online indication how PTC can increase my risks. Thank you that was helpful!

As I get older I feel the weight taking it's toll on my body and I have been on several supervised diets that were unsuccessful.  I was looking into the surgery because I have been battling with obesity my whole life, and saw a doctor this week to talk about weight loss surgery. I wasn't looking for treatment of PTC because I have not needed treatment for it in 4 years but when I mentioned it as part of my history to my doctor the risk of blindness came up.  He couldn't answer my questions because he knew little about it he just knew that PTC increases my risks.  

It seems that the risk is in the anesthesia and not the actual procedure...Is that correct? If I opted for something like the lapband I would still have the same risks. I know anesthesia can come with a lot of complications but PTC can cause complications as well. I have a mild permanent visual deficit from it in my right eye because it was undiagnosed for so long.

Does it make a difference if I have not had an episode of PTC or needed treatment for it in the past 4 years?

I'm still trying to do more research on this before I decide on anything but there is nothing out there! You have really helped thank you so much!!