Evaluation of postoperative intracranial pressure in patients with radiological diagnosis of idiopathic intracranial hypertension.

Autor: Barcia Castilla V; Skull Base and Rhinology Department, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil; Skull Base and Rhinology Department, Policlinica de Botafogo, Rio de Janeiro, Brazil. Electronic address: valeriabarciac@gmail.com., Vianna PM; Skull Base and Rhinology Department, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil., Torres RA; Skull Base and Rhinology Department, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil., Costa FMM; Skull Base and Rhinology Department, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil., Ramalho LL; Skull Base and Rhinology Department, Policlinica de Botafogo, Rio de Janeiro, Brazil., Garcez DC; Skull Base and Rhinology Department, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil. Electronic address: deboragarcez@hotmail.com., Pezato R; Federal University of São Paulo, Unifesp. Electronic address: pezatobau@gmail.com., Ramos BS; Skull Base and Rhinology Department, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil. Electronic address: sarnobia@gmail.com., Ferreira Bezerra JM; Skull Base and Rhinology Department, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil. Electronic address: bezerrajm@gmail.com., Tepedino MS; Skull Base and Rhinology Department, Hospital Universitario Pedro Ernesto, Rio de Janeiro, Brazil; Skull Base and Rhinology Department, Policlinica de Botafogo, Rio de Janeiro, Brazil.
Jazyk: angličtina
Zdroj: American journal of otolaryngology [Am J Otolaryngol] 2024 Dec 06; Vol. 46 (1), pp. 104542. Date of Electronic Publication: 2024 Dec 06.
DOI: 10.1016/j.amjoto.2024.104542
Abstrakt: Objective: This study aimed to assess postoperative intracranial pressure in patients with clinical and/or radiological features of idiopathic intracranial hypertension (IIH) undergoing endoscopic endonasal surgery for primary cerebrospinal fluid (CSF) leak repair.
Methods: Data was prospectively collected from 9 patients diagnosed with CSF nasal leaks who underwent corrective endonasal surgery between January 1, 2021, and October 31, 2022. Postoperative intracranial pressure was measured via lumbar puncture at least one month after surgery. Preoperative and postoperative MRI scans were compared to evaluate changes.
Results: Postoperative lumbar puncture revealed elevated intracranial pressure in 67 % of patients, and 100 % showed persistent signs of intracranial hypertension on MRI.
Conclusion: Managing elevated intracranial pressure in patients with CSF nasal leaks should be prioritized alongside surgical correction. Consideration of permanent peritoneal shunt or pharmacological treatment may be necessary for patients with classic IIH phenotype. Longitudinal studies are essential for further understanding long-term outcomes.
Competing Interests: Declaration of competing interest No conflicts of interest.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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