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Mathkour M, Scullen T, Kilgore MD, Gouveia EE, Chu J, Abou-Al-Shaar H, Tubbs RS, Khan F, Bui CJ. Complete ophthalmoplegia secondary to idiopathic intracranial hypertension managed successfully with dural sinus stenting: A case and systematic review. Clin Neurol Neurosurg 2021; 209:106910. [PMID: 34560385 DOI: 10.1016/j.clineuro.2021.106910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 08/15/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
Idiopathic Intracranial Hypertension (IIH) typically occurs in obese (BMI >30 kg/m2) females of childbearing age in the absence of any apparent intracranial space-occupying lesion. Patients typically present with headache, nausea, vomiting, tinnitus, and blurry vision secondary to increased intracranial pressure, with more severe cases involving cranial neuropathies and ophthalmological manifestations. Complete ophthalmoplegia is a rare event in IIH. In such cases, aggressive management with pharmacological, endovascular, and surgical intervention is essential to hasten recovery and limit long-term neurological and visual deficits. Herein, we present a rare case of a patient with IIH associated with third, fourth, and sixth cranial nerve palsies, resulting in complete unilateral ophthalmoplegia, who underwent dural sinus stenting and 2.5-year follow-up revealed complete resolution with full extraocular movements. We also perform a systematic literature review of complete and partial ophthalmoplegia secondary to IIH, highlighting the associated presentations, pathophysiology, management, and outcomes.
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Affiliation(s)
- Mansour Mathkour
- Ochsner Health System, Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA; Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA.
| | - Tyler Scullen
- Ochsner Health System, Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA; Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA.
| | - Mitchell D Kilgore
- Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA.
| | - Edna E Gouveia
- Ochsner Health System, Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA.
| | - Julie Chu
- Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA.
| | - Hussam Abou-Al-Shaar
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
| | - R Shane Tubbs
- Ochsner Health System, Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA; Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA.
| | - Fawad Khan
- The McCasland Family Comprehensive Headache Center, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA.
| | - Cuong J Bui
- Ochsner Health System, Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA; Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA.
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