A Case of Idiopathic Intracranial Hypertension Successfully Treated with Cerebrospinal Fluid Diversion

<p>　We report a case of idiopathic intracranial hypertension that was successfully treated with cerebrospinal fluid diversion. A 49-year-old woman was referred to the clinic for headache, photophobia, and temporary visual disturbances when looking down. Our study revealed normal visual acuity and papillary swelling in both eyes. Visual field testing showed mild enlargement of Marriotteʼs blind spots in both eyes. Magnetic resonance imaging showed no space-occupying lesions; however, enlarged subarachnoid space around the optic nerve and tortuosity of the intraorbital optic nerve could be seen, suggesting the presence of intracranial hypertension. She had an intractable headache and was referred to the Department of Neurosurgery, where a lumbar puncture showed a pressure of 35 cmH₂O, she was thus diagnosed with idiopathic intracranial hypertension. Conservative treatment showed no improvement in papilledema and the frequency of temporary visual disturbances. Lumbar abdominal shunt surgery was performed. Postoperatively, her papilledema improved, temporary visual disturbances and photophobia disappeared, headache and ear fullness disappeared, and visual acuity and visual field remained normal. In conservative treatment-resistant cases, timely surgical intervention before irreversible damage to the optic nerve by papilledema is important to preserve visual function.</p>