Resolution of pseudotumor cerebri after bariatric surgery for related obesity

Case report

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✓ Two obese women, both of whom were 42 years of age, were examined for pseudotumor cerebri. Intracranial venography revealed increased pressure in the dural venous sinuses and the right atrium. The increased right atrial pressure was attributable to the patients' obesity. Both patients underwent bariatric surgery to achieve weight loss. Approximately 1 year later, a clinical evaluation showed that in both women the pseudotumor cerebri had resolved. Repeated measurements of dural venous pressure indicated that the patients' pressures had returned to normal. Obese patients with pseudotumor cerebri and stable visual symptoms are best treated with weight loss to avoid shunt placement or optic nerve sheath fenestration.

Article Information

Contributor Notes

Address reprint requests to: Harold L. Rekate, M.D., c/o Neuroscience Publications, Barrow Neurological Institute, 350 West Thomas Road, Phoenix, Arizona 85013–4496. email: neuropub@chw.edu.
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References
  • 1.

    Alaud-din AMeterissian SLisbona Ret al: Assessment of cardiac function in patients who were morbidly obese. Surgery 108:8098201990Alaud-din A Meterissian S Lisbona R et al: Assessment of cardiac function in patients who were morbidly obese. Surgery 108:809–820 1990

    • Search Google Scholar
    • Export Citation
  • 2.

    Johnson LNKrohel GBMadsen RWet al: The role of weight loss and acetazolamide in the treatment of idiopathic intracranial hypertension (pseudotumor cerebri). Ophthalmology 105:231323171998Johnson LN Krohel GB Madsen RW et al: The role of weight loss and acetazolamide in the treatment of idiopathic intracranial hypertension (pseudotumor cerebri). Ophthalmology 105:2313–2317 1998

    • Search Google Scholar
    • Export Citation
  • 3.

    Karahalios DGRekate HLKhayata MHet al: Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology 46:1982021996Karahalios DG Rekate HL Khayata MH et al: Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology 46:198–202 1996

    • Search Google Scholar
    • Export Citation
  • 4.

    Rekate HLWallace D: Lumboperitoneal shunts in children. Pediatr Neurosurg 38:41462003Rekate HL Wallace D: Lumboperitoneal shunts in children. Pediatr Neurosurg 38:41–46 2003

    • Search Google Scholar
    • Export Citation
  • 5.

    Sugerman HJ: Effects of increased intra-abdominal pressure in severe obesity. Surg Clin North Am 81:106310752001Sugerman HJ: Effects of increased intra-abdominal pressure in severe obesity. Surg Clin North Am 81:1063–1075 2001

    • Search Google Scholar
    • Export Citation
  • 6.

    Sugerman HJDeMaria EJFelton WL IIIet al: Increased intraabdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri. Neurology 49:5075111997Sugerman HJ DeMaria EJ Felton WL III et al: Increased intraabdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri. Neurology 49:507–511 1997

    • Search Google Scholar
    • Export Citation
  • 7.

    Sugerman HJFelton WL IIISismanis Aet al: Gastric surgery for pseudotumor cerebri associated with severe obesity. Ann Surg 229:6346421999Sugerman HJ Felton WL III Sismanis A et al: Gastric surgery for pseudotumor cerebri associated with severe obesity. Ann Surg 229:634–642 1999

    • Search Google Scholar
    • Export Citation
  • 8.

    Sugerman HJSugerman ELWolfe Let al: Risks and benefits of gastric bypass in morbidly obese patients with severe venous stasis disease. Ann Surg 234:41462001Sugerman HJ Sugerman EL Wolfe L et al: Risks and benefits of gastric bypass in morbidly obese patients with severe venous stasis disease. Ann Surg 234:41–46 2001

    • Search Google Scholar
    • Export Citation
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