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Benign intracranial hypertension in pregnancyFrom: Kenneth Moise, MD (kmoise@bcm.tmc.edu)Thu Mar 5 21:11:01 1998
Would like to echo Bob Carpenter's post re: the treatment of benign intracranial hypertension in pregnancy. Just involved in a case this weekend requiring bilateral optic nerve decompression. Although this surgery would appear complicated at first glance (no pun intended), it is actually quite simple in experienced hands. The old method of removing part of the lateral bony orbit has been replaced by a soft tissue approach through the lateral lid under general anethesia. The globe is retracted medially and the optic nerve visualized. The sheath (dura and arachnoid layers) is incised thereby creating a CNS shunt. The excess fluid is absorbed by the soft tissues in the orbit. Usually one eye is done at a setting. In our case we did both eyes simultaneously with two opthamologists operating at 26 weeks' gestation. The entire procedure took 1.5 hours. Learned that visual fields Q 2 weeks are a must. If there are changes that are not reversed with diuretics and serial LP's - optic nerve decompression is a must. Unfortunately our patient will probably suffer long-term residual loss of sight because of optic atrophy. Ken Moise
-- Kenneth J. Moise, Jr., M.D. Professor, Department of Obstetrics and Gynecology Director, Division of Maternal-Fetal Medicine Baylor College of Medicine Houston, Texas Phone: 713-793-3539 FAX: 713-790-0108 Email: kmoise@bcm.tmc.edu
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