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Journal of Korean Neurosurgical Society 1994;23(7): 827-833.
Visual Loss Related to Papilledema:Report of 5 Cases.
Young Ho Suh, Man Bin Yim, Chang Chull Lee, Eun Ik Son, Dong Won Kim, In Hong Kim
Department of Neurosurgery, School of Medicine, Keimyung University, Taegu, Korea.
Five cases of complete visual loss related to papilledema were presented. The diagnoses of cases were an intracranial arachnoid cyst(1 case), brain tumors(3 cases) and benign intracranial hypertension(BIICP) followed by a minor head trauma(1 case). All cases had marked papilledema at admission and their range of age was from 4 to 27 years. The timings of visual loss were preadmission in 2 cases, during admission following removal of posterior fossa tumor(1 case) and revision of cysto-peritioneal shunt in a case of an arachnoid cyst(1 case), and during follow-up after conservative management of a minor head trauma(BIICP) in 1. Their visual function had not improved during the follow-up from 3 months to 9 years. Optic nerve sheath decompression should be considered in the case of BIICP for improving the vision. In cases who have well developed chronic papilledema, visual loss that is abrupt may be followed by cranial decompression. We stress neurosurgeons should predict a tragic outcome of visual loss during the management of cases who have well developed chronic papilledema, especially in children and young adult patients.
Key Words: Visual loss; Papilledema; Benign intracranial hypertension; Cranial decompression
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