Amir Aziz, Yaser-ud Din, Muhammad Airfn, Bashir Ahmed, Tariq Salahuddin.
LP Shunt, the Treatment of Choice in Idiopathic Intracranial Hypertension. (A 5 Years Experience at Lahore General Hospital, Lahore).
Pak J Neuro Surg Jan ;16(2):87-95.

Objective: The history, diagnosis, and therapy of idiopathic intracranial hypertension (IIH) are reviewed. Theories of pathogenesis are considered, the clinical presentation is described, and potential diagnostic and thera-peutic challenges are explored. Keeping in view all these things efficacy of L.P Shunt is observed. Material and Methods: A total of 35 patients were diagnosed as IHH according to the Modified Dandy’s criteria in our department from August 2007 to October 2012. An extensive literature review of IIH and related conditions was performed. The history of and rationale for the diagnosis and medical and surgical approaches to tre-atment are reviewed. Outcome of the patients’ with L.P shunt is observed.Study Design: Prospective and analytic study.Results: LP shunt addresses the cause of both headache and papilloedema more directly by effecting a global reduction of intracranial pressure. All patients underwent clinical, imaging, and CSF manometry evaluations. All patients showed failure or noncompliance to medical treatment and necessitated placement of an LP shunt. Among 35 patients who underwent LP shunt placement for IIH, 14 (40%) patients had severe and fulminant opening CSF pressures with values of more than 400 mm H2O. while in 21 (60%) patients opening CSF pressure was 260 to 400 mm H2O. symptoms of headache and papilloedema and visual obscuration improved in most of the patients. Shunt complications included two (0.7%) cases of shunt dislodgement and one (0.35%) case of shunt over drainage. Multiple potential contributing causes of intracranial hypertension must be excluded. On the basis of the advantages and disadvantages of different treatment modalities, we found L.P Shunt to be more effective and advantageous.Conclusion: Idiopathic intracranial hypertension is the diagnosis of exclusion. Medical therapy has a very little role in relieving signs and symptoms of this disease. L.P Shunt should be the treatment option in IIH.

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