¿Cual es el rol del tratamiento quirúrgico en el manejo de la hipertensión endocraneana idiopática refractaria al tratamiento médico?

Abstract

Purpose: To present our experience in the surgical treatment of idiopathic intracranial hypertension (IIH) with lumboperitoneal adjustable valve in children.
Methods: The overall study included 62 children under 18 years of age with IIH. All received treatment with Acetazolamide and/or Topiramate. In 9 cases due to lack of response to medical treatment, lumbar peritoneal shunts were placed. In 7 of these with a lumboperitoneal shunt adjustable valve.
Results: All 62 cases resolved the IIH either with medical or surgical treatment. In the surgical cases, the lumboperitoneal shunt adjustable valve permitted valve removal once IIH was resolved.
Conclusion: The use of lumboperitoneal shunt with an adjustable valve has the advantage of avoiding inserting a ventricular catheter in not enlarged ventricles avoiding cortical transgression, but most importantly, the ability to remove the valve once the patient is cured and thus avoiding shunt dependency for life.