Progressive visual loss due to obstruction of an optic nerve sheath fenestration demonstrated on SPECT/CT radionuclide cisternography.

摘要

A 35-year-old woman with a 7-year history of idiopathic intracranial hypertension (ICH) was referred for radionuclide cisternography. The symptoms of her ICH included severe migraines and bilateral visual loss. During the course of her illness the ICH was managed with insertion of cerebrospinal fluid (CSF) shunts. The duration of effect was limited due to the development of obstruction to drainage within these shunts. The progression of visual loss in the eyes prompted the creation of bilateral optic nerve sheath fenestration. This was performed 3 months before presentation. Despite this intervention the vision in the left eye continued to deteriorate. Radionuclide cisternography confirmed blockage of the left optic nerve sheath fenestration which responded to surgical decompression.