397460 tn?1268533736


Hi. I was diagnoised with IIH last July. I have papillodema in both eyes.Had a VP shunt fitted in Dec08.Opening pressure prior to shunt was 48/4800- post shunt, 30/3000.The next step that has been suggested is a second Vp shunt, to be done in the next 3 mths.
I have two questions; What are the stats for a successful second shunt? Will the paps  resolve as well as the headaches? To date, there has been no improvement in either.
I do trust my neuro and that he is doing all he can for me but I would like a second opinion before going thru  more surgery.
Any input would be most gratefully recieved. Cath278
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Avatar universal
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

When a VP shunt has been inserted and the headaches and papilledema persist and the pressure in the shunt is still elevated, the primary concern would be that the shunt is malfunctioning. Revision of the shunt, or insertion of a new one, is sometimes necessary. While I do not know the exact statistics of success of a second shunt, and I can not advise you for or against another shunt, in general, failure of one shunt does not necessarily imply failure of the second one.

With each surgery come certain risks (such as infection), but sometimes the risks are necessary if the IIH is not improving. If a second shunt is inserted and symptoms persist, other treatments such as venous stenting may be indicated if an MRV (an MRI of the veins of the brain) show narrowing of those veins.

Papilledema is expected to improve if the elevated CSF pressure is relieved appropriately, such as with a shunt (or second shunt). While vision may not improve (if the elevated pressure has been present for long enough), further progression of vision loss will be prevented. If papilledema is persistent and vision loss is occuring, then a procedure called optic nerve fenestration to relieve the pressure on the nerve may be indicated. This is a procedure done by opthalmologists.

Continued follow-up with your neurosurgeon is important. Discussion of the risks and benefits of the recommended second shunt insertion is recommended so you can understand the chances of success and make an informed decision.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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397460 tn?1268533736
Thank you very much for your reply.You have answered my questions and helped me to understand my situation a bit better. I will, of course, be keeping in close contact with my neurosurgeon. Heres hoping I have more success with the second shunt. Thank you again,Cath278.
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