Papilledema and acute visual loss in a patient with pseudotumor cerebri

Patient We report on a 30-year old female with bilateral visual loss within four days. She assured that she had been able to do computer-work until fo ur days before presentation. Ophthalmoscopy and echography established the diagnosis of a bilateral papilledema. Visual acuity was 20/500 in both eyes . Perimetry revealed a small central residual visual field. Further examina tions lead to the diagnosis of a primary pseudotumor cerebri. Clinical course and therapy Conservative treatment of the elevated intracra nial pressure and ventriculo-peritoneal shunting improved visual acuity and visual field and lead to a decrease of the papilledema. Follow up time was 30 months. Conclusion In a small number of patients pseudotumor cerebri presents with an acute visual loss. Immediate diagnosis and therapy can lead to an improv ement of vision.