The Use of Endoscopic Third Ventriculostomy as Treatment for Idiopathic Intracranial Hypertension: Case Report and a Review of Previously Reported Cases

Background: Idiopathic intracranial hypertension (IIH), or pseudotumor cerebri (PTC), is a rare disorder marked by the increase of CSF pressure that may cause severe headaches, papilledema, vision loss, and more. IIH is typically treated with shunts, but shunts are prone to malfunction and infection, resulting in many patients experiencing recurrent headaches post-treatment.

Case description: We present the case of a 41-year-old woman with IIH who exhibited a history of severe headaches and seizures with documented elevated intracranial pressure (OP: 250 mm H₂O). After the failure of several medical treatments, the patient was offered surgery for symptomatic relief. Given their ventricular anatomy and preference, the patient's IIH was treated with endoscopic third ventriculostomy (ETV) rather than the conventional shunt.

Conclusion: Reported resolution of the patient's headaches and improved quality of life following the procedure indicated that ETV can be used to treat IIH if ventricles are not completely slit-like. Additionally, we detail a review of all previously reported cases in which ETV was used for the treatment of IIH.

Keywords: 1. Endoscopic third ventriculostomy; 2. Idiopathic intracranial hypertension; 3. Lumboperitoneal shunt; 4. Ventriculoperitoneal shunt; 5. Treatment.