Cirurgia Bariátrica como possível tratamento para Pseudotumor cerebri: Caso Clínico

Abstract

Purpose: To report a case of a patient diagnosed with pseudotumor cerebri who presented symptomatic improvement after bariatric surgery for associated morbid obesity.

Result: A 42-year-old patient with morbidly obesity (body mass index of 44.4 kg/m2) and a history of kidney transplantation, went to the emergency department for complaints of loss of vision and refractory headache. The initial visual acuity was 4/10 and 10/10 in the right eye and left eye, respectively. A relative afferent pupillary defect was aimed at the right eye, bilateral papilledema, with normal neuroimaging, and an opening lumbar puncture pressure of 450 mmH₂O. She was initially treated with acetazolamide 500 mg and topiramate 75 mg but did not tolerate higher daily doses, so medical treatment was insufficient. Subsequently, the patient underwent a laparoscopic gastric sleeve procedure. One and a half year after the surgery, there was a 44% loss of body weight and no new episodes of headaches. Ophthalmological examination showed an improvement in visual acuity, papilledema and visual field test.

Conclusion: Bariatric surgery can significantly benefit patients with morbidly obese and pseudotumor cerebri.