الفهرس 
AnatomyOnly 14 pages are availabe for public view
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Abstract
Idiopathic intracranial hypertension [IIH] (also called benign intracranial hypertension or pseudotumor cerebri) is a condition characterised by raised intracranial pressure in the absence of a structural or vascular lesion, or ventriculomegaly or other identifiable causes of raised intracranial pressure such as certain medications.Idiopatic intracranial hypertension is usually diagnosed by the finding of elevated opening pressures when performing a lumbar puncture.
Surgery is considered when medical treatment fails, particularly with the worsening of visual symptoms or signs. Surgical options include cerebrospinal fluid (CSF) diversion and optic nerve fenestration. It is controversial whether either option is superior, and the choice of operation may depend on local expertise and resources
Lumbarperitoneal shunts are traditionally placed through an open approach. With minimally invasive surgery, laparoscopic transabdominal LP shunt has become possible.
The aim of the present study was to compare our results in placement of the abdominal tube of lumbo-peritoneal shunt using traditional method and laparoscopic assisted method in patient with idiopathic intracranial hypertension after failure of conservative treatment and repeated lumbar punctures.
This study included 20 patients operated with traditional method and 20 patients operated with laparoscopic assisted method prospectively and retrospectively for treatment of idiopathic intracranial hypertension after failure of conservative treatment and repeated lumbar punctures. This study conducted in our department of neurosurgery at Benha university hospital.
According to Preoperative paplledema, half of patient in the present study in both groups advanced Grade III paplledema before surgery and about the other half advanced Grade IV paplledema before surgery and only 3 patient had optic atrophy
According to operative data in both groups. The mean Time of surgery was significantly lower in Laparoscopic group than open group as The mean Time of surgery in Laparoscopic group was 1.33 ± 0.52 hour and was 2.58 ± 0.63 hour in open group (p < .00001). Blood loos during surgery was significantly lower in Laparoscopic group than open group (p = 0.004)
According to post-operative data in both groups. The mean Post operative stay was significantly lower in Laparoscopic group than open group as The mean Time of surgery in Laparoscopic group was 1.35 ± 0.47 day and was 3.35 ± 1.52 day in open group (p < .00001). Also rate of Complications was significantly lower in Laparoscopic group than open group ( p= 0.009)
Rate of Satisfaction was higher in Laparoscopic group than open group but with no statistically significant (p = 0.301)
According to Need for repeated surgeries, 8 patient in open group needed redo for once and 3 patients needed repeated surgeries for two times and one patient for 3 times. While in Laparoscopic group, Rate of repeated surgeries was lower, 2 patients needed redo for once and one patient needed repeated surgeries for two times . There was a statistically significant difference between both groups according to Need for repeated surgeries (p = 0.031)
from this results , we can conclude that the laparoscopic placement of lumbarperitoneal shunts is a safe and efficacious procedure in avoiding need for repeated surgeries ,intraoperative blood loss and hospital stay .It lowers the rate of postoperative complications and the time of surgery. It many advantages over the traditional minilaparotomy approach. The laparoscopic placement procedure should be particularly considered in obese patients with IIH.