Idiopathic intracranial hypertension: A case study of patient with lumbar peritoneal shunt in pregnancy

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Alvernia Neysa Ujat and Mohd Sofan Zenian

Queen Elizabeth Hospital, Malaysia

: J Spine Neurosurg

Abstract

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Idiopathic Intracranial Hypertension (IIH) is also known as benign intracranial hypertension or pseudotumor cerebri. This syndrome is characterized by; increased Intracranial Pressure (ICP) in the absence of any intracranial lesions or ventricular dilatation, normal cerebral spinal fluid composition, normal neurological examination with exception of papilloedema and occasionally CN VI palsy and normal conscious level. It is a diagnosis of exclusion. We presented a case study of IIH patient with Lumbar Peritoneal Shunt (LPS) in pregnancy. A case of 26 years old lady, diagnosed with post traumatic IIH in 2016. She was treated with LPS following failure of medical treatment; presented a year later to obstetrics clinic with unplanned pregnancy. She was otherwise well with no visual or raised ICP symptoms. Throughout pregnancy she was reviewed by both neurosurgery and obstetrics team to monitor disease progression. Serial fundoscopy examination revealed complete resolution of papilloedema. She was planned for spontaneous vaginal delivery with shortening of second stage of labor. The delivery was uneventful and both mother and child were discharged home well. Women with IIH will benefit from pre-conceptive counseling; as they would be prepared earlier on how IIH will implicated their pregnancy and vice versa. It should be highlighted that despite being diagnosed with IIH, they may still have normal pregnancy with spontaneous vaginal delivery without aggravating the disease course. Shortening the second stage of labor may reduce the risk of persistent elevated ICP in labor. Caesarean section should be offered purely due to obstetric indication.

Biography

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Alvernia Neysa Ujat has her expertise in a renowned Neurosurgery Department in Kota Kinabalu, Sabah. She has been doing her training as Resident since two years. She is heavily involved in managing neurosurgery patients and took part in managing patients from different sub-specialty that requires intensive care management with multidisciplinary approach. She is also actively taking part in researches, data collections and attending conferences to expose more on latest updates in neurosurgery.

E-mail: ardalia.a.neysa@gmail.com