Surgical management of pseudotumor cerebri in pregnancy: Case report

LITTLE HAS BEEN written concerning the surgical treatment of pregnant patients with pseudotumor cerebri. We present four cases of pregnant women who underwent lumboperitoneal shunt placement during pregnancy for progressive visual loss despite maximal medical therapy. The intraperitoneal pressure measured during surgery was significantly less than the cerebrospinal fluid pressure. Three of the four women had marked improvement in their vision after shunting, and one required optic nerve sheath decompressions for improvement. All delivered healthy babies. Pseudotumor cerebri in pregnant patients with progressive visual loss despite medical therapy is surgically treatable, and normal deliveries are expected. Therapeutic abortion to limit progression of the disease is not indicated.