An Official publication of The Asian Congress of Neurological Surgeons (AsianCNS)

Search Article
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Advertise Subscribe Contacts Login  Facebook Tweeter
  Users Online: 308 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
Year : 2014  |  Volume : 9  |  Issue : 3  |  Page : 153-157

Cervical puncture and perimedullary cistern shunt placement for idiopathic intracranial hypertension: An alternative to lumbar cistern or cerebral ventricular catheter placement a report of two cases

1 Department of Neurosurgery, University of Miami, Miller School of Medicine, Miami, FL, USA
2 Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA

Correspondence Address:
Dr. Mohammad Ali Aziz-Sultan
Department of Neurosurgery, Brigham and Women's Hospital, 75 Francis Street, PBB-311, Boston 02115, MA
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1793-5482.142735

Rights and Permissions

Objective: Idiopathic intracranial hypertension (IIH) is a syndrome characterized by increased intracranial pressure (ICP) in the absence of an identifiable cause, and if untreated, can result in permanent vision loss. In symptomatic IIH patients, cerebrospinal fluid (CSF) diversion can lower ICP and protect vision; however, currently used CSF diversion systems are prone to malfunction in this population. Materials and Methods: In two IIH patients with histories of numerous prior shunt revisions that presented with proximal ventriculoperitoneal shunt malfunction, ICP reduction was achieved by an alternative surgical cerebrospinal fluid (CSF) diversion technique: Fluoroscopically guided, percutaneous placement of a catheter in the premedullary cistern and subsequent connection to the valve and distal shunt system. Results: Postoperatively, both patients' papilledema resolved, headaches improved, and the shunts were working well at 3-month follow-up. At 1-year follow-up, one patient was well without papilledema or symptom recurrence, and the second patient had the shunt system removed by an outside surgeon. Conclusion: This technique may hold promise as an alternative shunting strategy in IIH patients with numerous proximal shunt failures or who are poor candidates for ventricular and lumbar shunts.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded268    
    Comments [Add]    
    Cited by others 1    

Recommend this journal