Skip to main content

Advertisement

SpringerLink
Log in

Idiopathic intracranial hypertension occurred after spinal surgery: report of two rare cases and systematic review of the literature

  • Case Report
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Background

Idiopathic intracranial hypertension (IIH) is a relatively rare syndrome of increased intracranial pressure of unknown etiology. It is characterized by cerebrospinal fluid (CSF) opening pressure more than 250 mmH2O, with normal cranial imaging and CSF content. IIH occurred after spinal surgery is extremely rare.

Methods

We present two IIH cases occurred after spinal surgery and conduct a systematic review of articles reporting IIH occurred after spinal surgery.

Results

The first patient underwent a posterior decompression and fixation for cervical fractures. IIH symptoms appeared 3 days postoperatively and gradually resolved with appropriate medication. The second patient underwent posterior spinal fusion with segmental instrumentation for congenital scoliosis. IIH symptoms appeared 5 days postoperatively and the patient died due to the irreversible intracranial hypertension although underwent intensive care and treatment. The literature review revealed that there were only five cases of IIH occurred after spinal surgery reported till date.

Conclusions

IIH occurred after spinal surgery is relatively rare; the diagnosis is based upon exclusion of other diseases. IIH should be kept in mind in patients underwent spinal surgery as it could develop into irreversible intracranial hypertension.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Friedman DI, Liu GT, Digre KB (2013) Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 81:1159–1165. doi:10.1212/WNL.0b013e3182a55f17

    Article  PubMed  Google Scholar 

  2. Shin RK, Balcer LJ (2002) Idiopathic intracranial hypertension. Curr Treat Options Neurol 4:297–305

    Article  PubMed  Google Scholar 

  3. Binder DK, Horton JC, Lawton MT, McDermott MW (2004) Idiopathic intracranial hypertension. Neurosurgery 54:538–551 (discussion 551–552)

    Article  PubMed  Google Scholar 

  4. Thurtell MJ, Wall M (2013) Idiopathic intracranial hypertension (pseudotumor cerebri): recognition, treatment, and ongoing management. Curr Treat Options Neurol 15:1–12. doi:10.1007/s11940-012-0207-4

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bidot S, Bruce BB (2015) Update on the diagnosis and treatment of idiopathic intracranial hypertension. Semin Neurol 35:527–538. doi:10.1055/s-0035-1563569

    Article  PubMed  Google Scholar 

  6. Quincke H (1893) Meningitis serosa. Samml Klin Vortr 67:1

    Google Scholar 

  7. Smith JL (1985) Whence pseudotumor cerebri? J Clin Neuroophthalmol 5:55–56

    CAS  PubMed  Google Scholar 

  8. Friedman DI, Jacobson DM (2002) Diagnostic criteria for idiopathic intracranial hypertension. Neurology 59:1492–1495

    Article  PubMed  Google Scholar 

  9. Corbett JJ, Thompson HS (1989) The rational management of idiopathic intracranial hypertension. Arch Neurol 46:1049–1051

    Article  CAS  PubMed  Google Scholar 

  10. Brazis PW (2007) Profiles of obesity, weight gain, and quality of life in idiopathic intracranial hypertension. Am J Ophthalmol 143:683–684. doi:10.1016/j.ajo.2007.01.001

    Article  PubMed  Google Scholar 

  11. Dandy WE (1937) Intracranial pressure without brain tumor: diagnosis and treatment. Ann Surg 106:492–513

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Durcan FJ, Corbett JJ, Wall M (1988) The incidence of pseudotumor cerebri. Population studies in Iowa and Louisiana. Arch Neurol 45:875–877

    Article  CAS  PubMed  Google Scholar 

  13. Craig JJ, Mulholland DA, Gibson JM (2001) Idiopathic intracranial hypertension; incidence, presenting features and outcome in Northern Ireland (1991–1995). Ulster Med J 70:31–35

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Chen J, Wall M (2014) Epidemiology and risk factors for idiopathic intracranial hypertension. Int Ophthalmol Clin 54:1–11. doi:10.1097/IIO.0b013e3182aabf11

    Article  PubMed  Google Scholar 

  15. McCluskey G, Mulholland DA, McCarron P, McCarron MO (2015) Idiopathic Intracranial Hypertension in the Northwest of Northern Ireland: epidemiology and clinical management. Neuroepidemiology 45:34–39. doi:10.1159/000435919

    Article  PubMed  Google Scholar 

  16. Kesler A, Kupferminc M (2013) Idiopathic intracranial hypertension and pregnancy. Clin Obstet Gynecol 56:389–396. doi:10.1097/GRF.0b013e31828f2701

    Article  PubMed  Google Scholar 

  17. Falardeau J, Lobb BM, Golden S, Maxfield SD, Tanne E (2013) The use of acetazolamide during pregnancy in intracranial hypertension patients. J Neuroophthalmol 33:9–12. doi:10.1097/WNO.0b013e3182594001

    Article  PubMed  Google Scholar 

  18. Krishnakumar D, Pickard JD, Czosnyka Z, Allen L, Parker A (2014) Idiopathic intracranial hypertension in childhood: pitfalls in diagnosis. Dev Med Child Neurol 56:749–755. doi:10.1111/dmcn.12475

    Article  PubMed  Google Scholar 

  19. Salpietro V, Chimenz R, Arrigo T, Ruggieri M (2013) Pediatric idiopathic intracranial hypertension and extreme childhood obesity: a role for weight gain. J Pediatr 162:1084. doi:10.1016/j.jpeds.2013.01.048

    Article  PubMed  Google Scholar 

  20. Daftari TK, Heller JG, Newman NJ (1995) Pseudotumor cerebri after occipitocervical arthrodesis and immobilization in a halo vest. A case report. J Bone Joint Surg Am 77:455–458

    Article  CAS  PubMed  Google Scholar 

  21. Sussman WI, Shaw E (2014) Intracranial hypertension after spinal cord injury and suboptimal cervical fusion. PM R 6:199–202. doi:10.1016/j.pmrj.2013.08.595

    Article  PubMed  Google Scholar 

  22. Kunes J, Thompson GH, Manjila S, Poe-Kochert C, Cohen AR (2011) Idiopathic intracranial hypertension following spinal deformity surgery in children. Neurosurg Focus 31:E20. doi:10.3171/2011.7.FOCUS11160

    Article  PubMed  Google Scholar 

  23. De Simone R, Ranieri A, Bonavita V (2010) Advancement in idiopathic intracranial hypertension pathogenesis: focus on sinus venous stenosis. Neurol Sci 31(Suppl 1):S33–S39. doi:10.1007/s10072-010-0271-z

    Article  PubMed  Google Scholar 

  24. Skau M, Brennum J, Gjerris F, Jensen R (2006) What is new about idiopathic intracranial hypertension? An updated review of mechanism and treatment. Cephalalgia 26:384–399. doi:10.1111/j.1468-2982.2005.01055.x

    Article  CAS  PubMed  Google Scholar 

  25. Nedelmann M, Kaps M, Mueller-Forell W (2009) Venous obstruction and jugular valve insufficiency in idiopathic intracranial hypertension. J Neurol 256:964–969. doi:10.1007/s00415-009-5056-z

    Article  PubMed  Google Scholar 

  26. Biousse V, Bruce BB, Newman NJ (2012) Update on the pathophysiology and management of idiopathic intracranial hypertension. J Neurol Neurosurg Psychiatry 83:488–494. doi:10.1136/jnnp-2011-302029

    Article  PubMed  PubMed Central  Google Scholar 

  27. Friesner D, Rosenman R, Lobb BM, Tanne E (2011) Idiopathic intracranial hypertension in the USA: the role of obesity in establishing prevalence and healthcare costs. Obes Rev 12:e372–e380. doi:10.1111/j.1467-789X.2010.00799.x

    Article  CAS  PubMed  Google Scholar 

  28. Patton N, Beatty S, Lloyd IC (2000) Bilateral sixth and fourth cranial nerve palsies in idiopathic intracranial hypertension. J R Soc Med 93:80–81

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Cinciripini GS, Donahue S, Borchert MS (1999) Idiopathic intracranial hypertension in prepubertal pediatric patients: characteristics, treatment, and outcome. Am J Ophthalmol 127:178–182

    Article  CAS  PubMed  Google Scholar 

  30. Tang RA, Dorotheo EU, Schiffman JS, Bahrani HM (2004) Medical and surgical management of idiopathic intracranial hypertension in pregnancy. Curr Neurol Neurosci Rep 4:398–409

    Article  PubMed  Google Scholar 

  31. Supuran CT (2015) Acetazolamide for the treatment of idiopathic intracranial hypertension. Expert Rev Neurother 15:851–856. doi:10.1586/14737175.2015.1066675

    Article  CAS  PubMed  Google Scholar 

  32. Johnson LN, Krohel GB, Madsen RW, March GA Jr (1998) The role of weight loss and acetazolamide in the treatment of idiopathic intracranial hypertension (pseudotumor cerebri). Ophthalmology 105:2313–2317. doi:10.1016/S0161-6420(98)91234-9

    Article  CAS  PubMed  Google Scholar 

  33. Victorio MC, Rothner AD (2013) Diagnosis and treatment of idiopathic intracranial hypertension (IIH) in children and adolescents. Curr Neurol Neurosci Rep 13:336. doi:10.1007/s11910-012-0336-x

    Article  PubMed  Google Scholar 

  34. Kosmorsky GS (2014) Idiopathic intracranial hypertension: pseudotumor cerebri. Headache 54:389–393. doi:10.1111/head.12284

    Article  PubMed  Google Scholar 

  35. El-Saadany WF, Farhoud A, Zidan I (2012) Lumboperitoneal shunt for idiopathic intracranial hypertension: patients’ selection and outcome. Neurosurg Rev 35:239–243. doi:10.1007/s10143-011-0350-5 (discussion 243–244)

    Article  PubMed  Google Scholar 

  36. Rogers DL (2014) A review of pediatric idiopathic intracranial hypertension. Pediatr Clin N Am 61:579–590. doi:10.1016/j.pcl.2014.03.004

    Article  Google Scholar 

  37. Uretsky S (2009) Surgical interventions for idiopathic intracranial hypertension. Curr Opin Ophthalmol 20:451–455. doi:10.1097/ICU.0b013e3283313c1c

    Article  PubMed  Google Scholar 

  38. Spitze A, Malik A, Lee AG (2014) Surgical and endovascular interventions in idiopathic intracranial hypertension. Curr Opin Neurol 27:69–74. doi:10.1097/WCO.0000000000000049

    Article  PubMed  Google Scholar 

  39. Rizzo JL, Lam KV, Wall M, Wilson MD, Keltner JL (2015) Perimetry, retinal nerve fiber layer thickness and papilledema grade after cerebrospinal fluid shunting in patients with idiopathic intracranial hypertension. J Neuroophthalmol 35:22–25. doi:10.1097/WNO.0000000000000181

    Article  PubMed  PubMed Central  Google Scholar 

  40. Dhungana S, Sharrack B, Woodroofe N (2010) Idiopathic intracranial hypertension. Acta Neurol Scand 121:71–82. doi:10.1111/j.1600-0404.2009.01172.x

    Article  CAS  PubMed  Google Scholar 

  41. Wall M, George D (1991) Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain 114(Pt 1A):155–180

    PubMed  Google Scholar 

  42. Corbett JJ, Savino PJ, Thompson HS, Kansu T, Schatz NJ, Orr LS, Hopson D (1982) Visual loss in pseudotumor cerebri. Follow-up of 57 patients from five to 41 years and a profile of 14 patients with permanent severe visual loss. Arch Neurol 39:461–474

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the Grants from the National Nature Science Foundation of China (Nos. 81171756 and 81501908) and the Nature Science Foundation of Zhejiang Province (LY14H60004).

Author information

Author notes

    Authors and Affiliations

    1. Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jie Fang Road, Hangzhou, 310009, China

      Zhengkuan Xu, Hao Li, Gang Chen, Fangcai Li, Shenjun Qian & Qixin Chen

    Authors
    1. Zhengkuan Xu
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Hao Li
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Gang Chen
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Fangcai Li
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Shenjun Qian
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Qixin Chen
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Qixin Chen.

    Ethics declarations

    Conflict of interest

    None of the authors has any potential conflict of interest.

    Additional information

    Z. Xu and H. Li contributed equally to this work.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Xu, Z., Li, H., Chen, G. et al. Idiopathic intracranial hypertension occurred after spinal surgery: report of two rare cases and systematic review of the literature. Eur Spine J 26 (Suppl 1), 9–16 (2017). https://doi.org/10.1007/s00586-016-4578-1

    Download citation

    • Received:

    • Revised:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00586-016-4578-1

    Keywords

    Search

    Navigation