Skip to main content
Log in

Transient blindness following intracranial pressure changes in a hydrocephalic child with a V-P shunt

  • Original Papers
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

A hydrocephalic child with a V-P shunt developed transient blindness following shunt revision. A year later, visual function deteriorated when shunt malfunction occurred. Following shunt revision, the child regained sight. The effects of intracranial hypertension and hypotension on the visual pathways are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alani SM (1985) Patten reversal visual evoked potentials in patients with hydrocephalus. J Neurosurg 62:234–237

    Article  CAS  Google Scholar 

  2. Arroyo HA, Jan JE, McCormick AQ, Farrell K (1985) Permanent visual loss after shunt malfunction. Neurology 35:25–29

    Article  CAS  Google Scholar 

  3. Blanks JP, Mcpherson D, Foltz EL (1985) Acute negative intracranial pressure, effects on the auditory evoked response in rabbits. Neurosurgery 17:877–882

    Article  CAS  Google Scholar 

  4. Calogero JA, Alexander E Jr (1971) Unilateral amaurosis in a hydrocephalic child with an obstructed shunt. J Neurosurg 34:236–240

    Article  CAS  Google Scholar 

  5. Cushing H, Walker CB (1912) Distortion in visual fields in cases of brain tumor. Arch Ophthalmol 41:559–598

    Google Scholar 

  6. Drymalsky WG (1980) Cortical blindness: the changing incidence and shifting etiology. Postgrad Med 67:149–156

    Article  Google Scholar 

  7. Engel RC (1975) Abnormal electroencephalogram in the neonatal period. Thomas, Springfield, Ill, pp 106–116

    Google Scholar 

  8. Epstein FJ, Fleischer AS, Hochwald GM, Aanshoff J (1974) Subtemporal craniectomy for recurrent shunt obstruction secondary to small ventricles. J Neurosurg 41:29–31

    Article  CAS  Google Scholar 

  9. Epstein F, Marlin AF, Wald A (1978) Chronic headache in the shunt dependent adolescent with nearly normal ventricular volume: diagnosis and treatment. Neurosurgery 351–355

    Article  CAS  Google Scholar 

  10. Faulhaber K, Schmitz P (1978) Overdrainage phenomenon in shunt treated hydrocephalus. Acta Neurochir (Wien) 45:89–101

    Article  Google Scholar 

  11. Fishsel H (1976) Changes in visual evoked potentials in children with progressive hydrocephalus. Fortschr Med 94:1141–1142

    Google Scholar 

  12. Forrest DM, Cooper DJW (1968) Complication of ventriculoatrial shunting: a review of 455 cases. J Neurosurg 29:506–512

    Article  Google Scholar 

  13. Grievel R, Khan M, Tan L (1985) CSF, shunt complications; an analysis of contributory factors. Child's Nerv Syst 1:77–80

    Article  Google Scholar 

  14. Guthkelch AN, Scalabassi KJ, Hirch RP, Vries JK (1984) Visual evoked potential in hydrocephalus: relationship to head size, shunting and mental development. Neurosurgery 14:283–286

    Article  CAS  Google Scholar 

  15. Halliday AM, McDonald WI, Mushin J (1972) Delayed visual evoked response in optic neuritis. Lancet I:982–985

    Article  Google Scholar 

  16. Halliday AM, Halliday E, Kriss A, McDonald WI, Mushin J (1976) The pattern evoked potential in compression of the anterior visual pathways. Brain 99:357–374

    Article  CAS  Google Scholar 

  17. Harcourt RB (1968) Ophthalmic complication of meningomyelocele and hydrocephalus in children. Br J Ophthalmol 52:670–676

    Article  CAS  Google Scholar 

  18. Hayreh SS (1977) Optic disk edema in raised intra cranial pressure. Associated visual disturbances and their pathogenesis. Arch Ophthalmol 95:1566–1579

    Article  CAS  Google Scholar 

  19. Hoyt WF (1960) Vascular lesions of the cortex with brain herniation through the tentorial incisura. Arch Ophthalmol 64:44–57

    Article  CAS  Google Scholar 

  20. Hoyt WF, Rios Montenegegro EN, Behrens MM, (1972) Homonimus hemioptic hypoplasia. Fundoscopic features in standard and red free illumination in three patients with congenital hemiplegia. Br J Ophthalmol 56:537–545

    Article  CAS  Google Scholar 

  21. Humphrery P, Moseley I, Russel R (1982) Visual field defects in obstructive hydrocephalus. J Neurol Neurosurg Psychiatry 45:591–597

    Article  Google Scholar 

  22. Jan JE, Robinson GC, Kinnis C, Macleod PJM (1977) Blindness due to optic nerve atrophy and hypoplasia in children. Dev Med Child Neurol 19:353–363

    Article  CAS  Google Scholar 

  23. Keane JR (1980) Blindness following tentorial herniation. Ann Neurol 8:186–190

    Article  CAS  Google Scholar 

  24. Keen JH (1973) Blindness in children with myelomeningocele and hydrocephalus. Dev Med Child Neurol [Suppl] 15:112

    Google Scholar 

  25. Keucher TR, Medley J (1979) Long term results after ventriculo-atrial and ventriculo-peritoneal shunting for infantile hydrocephalus. J Neurosurg 50:179–186

    Article  CAS  Google Scholar 

  26. Lorber J (1967) Recovery of vision following prolonged blindness in children with hydrocephalus or following pyogenic meningitis. Clin Pediatr (Phil) 6:699–703

    Article  CAS  Google Scholar 

  27. Lundenberg R, Walsh FB (1964) Vascular compressions involving intra cranial visual pathways. Trans Ann Acad Ophthalmol Otolaryngol 68:677–694

    Google Scholar 

  28. Lundstrom M, Friesen L (1975) Evolution of descending optic atrophy. Acta Ophthalmol (Copenh) 53:738–746

    Article  CAS  Google Scholar 

  29. McCulhough DC, Fox JC (1974) Negative intracranial pressure hydrocephalus in adults with shunts and its relationship to the production of subdural hematoma. J Neurosurg 40:372–375

    Article  Google Scholar 

  30. Moore MT, Stern K (1938) Vascular lesions of the brain stem and occipital lobe occurring in association with brain tumor. Brain 61:70–98

    Article  Google Scholar 

  31. Portnoy HD, Schulte RR, Fox JC (1973) Antisiphon and reversible occlusion valves for shunting in hydrocephalus and preventing post-shunt subdural hematoma. J Neurosurg 38:729–734

    Article  CAS  Google Scholar 

  32. Raimondi AJ, Robinson JS, Kuwamura K (1977) Complication of ventriculoperitoneal shunting. Child's Brain 3:321–342

    CAS  PubMed  Google Scholar 

  33. Robinson F (1967) Influence of increased intracranial pressure on evoked responses to sensory stimulation. Electroencephalogr Clin Neurophysiol 23:96

    CAS  PubMed  Google Scholar 

  34. Rossini P, Gambi D, Di Rocco C, Solazzo D (1978) Study of visual evoked potentials in children with hydrocephalus. Rev Neurol 48:594–598

    CAS  Google Scholar 

  35. Salah S, Sunder-Plassmann M, Zaumbaur F, Koos W (1978) The use of the anti-siphon valve in prevention of functional complications of shunting systems. In: Wüllenweber R, Wenker H, Brock M (eds) Treatment of hydrocephalus. Computer tomography. (Advances in neurosurgery, vol 6) Springer, Berlin Heidelberg New York, pp 42–44

    Chapter  Google Scholar 

  36. Salmon JH (1978) The collapsed ventricle: management and prevention. Surg Neurol 9:349–352

    CAS  PubMed  Google Scholar 

  37. Samuelson S, Long DM, Chou SN (1972) Subdural hematoma as a complication of shunting procedure for normal pressure hydrocephalus. J Neurosurg 37:548–551

    Article  CAS  Google Scholar 

  38. Sayers MP (1976) Shunt complications. Clin Neurosurg 26:393–400

    Article  Google Scholar 

  39. Sekhar LN, Moossy J, Gutkeich AN (1982) Malfunctioning ventriculoperitoneal shunts: clinical and pathological features. J Neurosurg 56:411–416

    Article  CAS  Google Scholar 

  40. Shucart WA, Connolly R (1975) Experimental negative intraventricular pressure. J Surg Res 19:43–46

    Article  CAS  Google Scholar 

  41. Sklar FH, Ehle AL, Clark WK (1979) Visual evoked potentials; a non-invasive technique to monitor patients with shunted hydrocephalus. Neurosurgery 6:529–534

    Article  Google Scholar 

  42. Smith JL (1967) Cortical blindness in congenital hydrocephalus, chap 18. In: Smith JL (ed) Neurophthalmology, vol 3. Mosby, St Louis, Mo, pp 211–217

    Google Scholar 

  43. Steinbock P, Thompson JB (1976) Complications of ventriculo-vascular shunts. Computer analysis of ethiological factors. Surg Neurol 5:31–35

    Google Scholar 

  44. Sunderland S (1958) The tentorial notch and complication produced by herniation of the brain. Br J Surg 45:422–438

    Article  CAS  Google Scholar 

  45. Toledo E, Eynan N, Shalit M (1980) Intracranial hypotension — an iatrogenic complication of vacuum drainage systems. Acta Neurochir (Wien) 52:55–59

    Article  CAS  Google Scholar 

  46. Van Buren JM (1963) Transsynaptic retrograde degeneration in the visual system of primates. J Neurol Neurosurg Psychiatry 26:402–409

    Article  Google Scholar 

  47. Wagener HP, Cusick PL (1937) Chiasmal syndromes produced by lesions of the posterior fossa. Arch Ophthalmol 18:887–891

    Article  Google Scholar 

  48. Walsh FB, Hoyt WF (1964) In: Walsh FB, Hoyt WF (eds) Clinical neuroophthalmology, vol 1. Williams & Wilkins, Baltimore, pp 1–129

    Google Scholar 

  49. Weller RO, Shulman K (1972) Infantile hydrocephalus. Clinical histological and ultrastructural study of brain damage. J Neurosurg 36:255–265

    Article  CAS  Google Scholar 

  50. Wybar K (1976) Optic atrophy in childhood. Proc R Soc Med 69:451–459

    CAS  PubMed  PubMed Central  Google Scholar 

  51. York DH, Pulliam MW, Rosenfeld JG, Watts C (1981) Relationship between visual evoked potentials and intracranial pressure. J Neurosurg 55:909–916

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Constantini, S., Umansky, F., Nesher, R. et al. Transient blindness following intracranial pressure changes in a hydrocephalic child with a V-P shunt. Child's Nerv Syst 3, 379–381 (1987). https://doi.org/10.1007/BF00270713

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00270713

Key words

Navigation