Sunken Eyes, Sagging Brain- New Syndrome

November 16, 2011

Ophthalmology: Researchers describe a syndrome of chronic intracranial hypotension due to ventriculoperitoneal shunt for pseudotumor which works too well.  They describe four patients who develop cosmetically obvious enophthalmos, sometimes to such a degree that the lids cannot wipe the eyes normally and they develop blindness due to exposure keratopathy. The low ICP allows the orbit to expand with no fat atrophy, and CT reveal shortened, straight optic nerves. Interesting and rare. If the shunt cannot be revised, the authors wonder if surgical olume replacement may be of benefit.




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