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Virtual Prism Adaptation Therapy: Protocol for Validation in Healthy Adults
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Published on: February 12, 2020

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Escape from prism.

Michael C Brodsky1, Bryce J Aul2, David J Daniels3

  • 1Department of Departments of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN, USA.

Survey of Ophthalmology
|February 19, 2022
PubMed
Summary

A boy with shunted hydrocephalus experienced symptoms like headaches and double vision. Prompt shunt replacement resolved his condition, highlighting clinical assessment importance.

Keywords:
Hydrocephalusintracranial pressurepapilledemaventriculoperitoneal shunt failure

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Area of Science:

  • Neurology
  • Neurosurgery
  • Ophthalmology

Background:

  • Congenital hydrocephalus requires ongoing management, often involving cerebrospinal fluid shunts.
  • Shunt malfunction can lead to serious neurological complications if not promptly addressed.

Observation:

  • A 14-year-old boy with a history of shunted hydrocephalus presented with headaches, nausea, vomiting, and horizontal diplopia after air travel.
  • Initial neuro-ophthalmologic examination revealed bilateral sixth nerve palsy without papilledema or ventriculomegaly; intracranial pressure monitoring was normal.

Findings:

  • Despite normal initial intracranial pressure readings, the patient later developed papilledema, indicating increased intracranial pressure.
  • Surgical exploration confirmed shunt malfunction, and subsequent shunt replacement led to rapid symptom resolution.

Implications:

  • This case underscores the critical role of clinical history and detailed neuro-ophthalmologic examination in diagnosing shunt failure.
  • It emphasizes that objective measures of intracranial pressure may not always reflect the true clinical picture in hydrocephalus patients.
  • Early recognition and intervention based on clinical signs are vital for managing suspected cerebrospinal fluid shunt dysfunction.