Resolution of pseudotumor cerebri after bariatric surgery for related obesity. Case report

Two obese women, both of whom were 42 years of age, were examined for pseudotumor cerebri. Intracranial venography revealed increased pressure in the dural venous sinuses and the right atrium. The increased right atrial pressure was attributable to the patients' obesity. Both patients underwent bariatric surgery to achieve weight loss. Approximately 1 year later, a clinical evaluation showed that in both women the pseudotumor cerebri had resolved. Repeated measurements of dural venous pressure indicated that the patients' pressures had returned to normal. Obese patients with pseudotumor cerebri and stable visual symptoms are best treated with weight loss to avoid shunt placement or optic nerve sheath fenestration.