Impending Blindness by Obstructive Hydrocephalus Intractable to Endoscopic Third Ventriculostomy: Case Report

Abstract Endoscopic third ventriculostomy (ETV) has been accepted for obstructive hydrocephalus (OH). We herein present a case of OH and optic nerve sheath edema (ONSE). Although ETV was successful, ONSE worsened. Discussion is focused on the relationship among intracranial hypertension (IH), ETV, ONSE. The patient 19-year-old woman with complaints headache emesis. Papilledema prominent. Radiological examination showed as an aqueductal tumor. tumorectomy were accomplished. emesis disappeared, papilledema persisted. On 4th day, lost light perception. magnetic resonance imaging, ventricular stroma aqueduct patent. Nevertheless, After lumbar drainage, her vision restored. Finally, ventriculoperitoneal shunting performed, following which disappeared. IH not always accompanied by However, once it occurs, may act separately from IH, even exacerbate due to alteration cerebrospinal fluid (CSF) flow into chiasmatic cistern. In sheath, CSF pressure easily transmitted across different areas; this should explain dissociation between other symptoms IH. Furthermore, we suggest that acute dysfunction be considered independent crisis “hydronervus opticus.”