Posterior Reversible Encephalopathy Syndrome and Subarachnoid Hemorrhage After Lumboperitoneal Shunt for Fulminant Idiopathic Intracranial Hypertension

J Neuroophthalmol. 2016 Jun;36(2):164-6. doi: 10.1097/WNO.0000000000000355.

Abstract

A 33-year-old woman presented with severe visual loss from fulminant idiopathic intracranial hypertension. Her lumbar puncture opening pressure was 97 cm H2O. Soon after lumboperitoneal shunt surgery, she had a generalized tonic-clonic seizure. Magnetic resonance imaging demonstrated frontal subarachnoid hemorrhage (SAH) and neuroimaging findings consistent with posterior reversible encephalopathy syndrome (PRES). We hypothesize that an abrupt drop in intracranial pressure after lumboperitoneal shunting led to maladjustment of cerebral vascular autoregulation, which caused SAH and PRES.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Humans
  • Intracranial Pressure
  • Magnetic Resonance Imaging
  • Posterior Leukoencephalopathy Syndrome / diagnosis
  • Posterior Leukoencephalopathy Syndrome / etiology*
  • Postoperative Complications*
  • Pseudotumor Cerebri / diagnosis
  • Pseudotumor Cerebri / surgery*
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / etiology*
  • Ventriculoperitoneal Shunt / adverse effects*