Ramsey Christian N, Proctor Ben L, Baker Robert S, Pittman Thomas
Department of Surgery, Division of Neurosurgery, University of Kentucky, Lexington, Kentucky 40536-0298, USA.
J Neurosurg. 2006 Feb;104(2 Suppl):149-51. doi: 10.3171/ped.2006.104.2.13.
Ophthalmological problems such as papilledema, loss of visual acuity, and oculomotor palsies are common in patients with shunt malfunctions. The authors report on three patients with shunts who presented with visual loss. In each case, the diagnosis of shunt malfunction was delayed because other classic signs and symptoms of intracranial hypertension were absent. All three patients underwent optic nerve sheath fenestration (ONSF) with resultant stabilization or improvement of visual symptoms before the shunt malfunction was recognized and treated. Consideration of these cases suggests a potential protective role of ONSF for patients with shunt malfunction.
