Idiopathic Intracranial Hypertension and Endoscopic Optic Nerve Sheath Fenestration

Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):972-975. doi: 10.1007/s12070-020-02004-7. Epub 2020 Aug 13.

Abstract

Idiopathic intracranial hypertension (IIH), also called as benign intracranial hypertension is a disorder, which is considered benign in its course except its' ill effects on vision. Ocular findings in IIH such as papilledema, macular changes, retinal micro haemorrhages, cotton wool spots and tortuosity of vessels are the prominent features in funduscopy examination in these patients. Papilledema is a hallmark feature for evaluation of response to treatment. Ophthalmological rescue is a primary goal of management of idiopathic intracranial hypertension. Among the treatment options described in literature, optic nerve sheath fenestration is a minimally invasive endoscopic technique for the rescue of vision. We present this case-report, which will help ophthalmologists and the surgeons to determine the significance of the funduscopy changes after optic nerve sheath fenestration and help in decision making.

Keywords: IIH; Idiopathic intracranial hypertension; ONSD; Optic nerve fenestration; Optic nerve sheath decompression procedure; Visual deterioration with papilledema.