Validity of Ultrasound Guided Placement of Ventriculoperitoneal Shunts in Patients with Idiopathic Intracranial Hypertension

Background: Idiopathic intracranial hypertension is a pres-sure-related brain disorder strongly linked to obesity, with po-tential for progressive or sudden vision loss. Aim of Study: To evaluate the accuracy and clinical validity of ultrasound-guided placement of ventriculoperitoneal (VP) shunts in patients with idiopathic intracranial hypertension. Patients and Methods: This prospective research has been performed on 20 consecutive cases with the diagnosis of idio-pathic intracranial hypertension, who were admitted to Neuro-surgery Department, Alexandria University, Alexandria, Egypt. Results: Magnetic resonance imaging (MRI) revealed that partial empty sella was the majority of frequent finding among cases. Preoperative cerebrospinal fluid (CSF) opening pressure, measured in the lateral decubitus position, ranged from 27 to 39 cmH2O, with 50% of cases falling between 30.0 and 34.9 cmH2O. Most surgeries proceeded smoothly; however, a few cases faced intraoperative difficulties, including challenging ventricular access or obesity-related issues that prolonged oper-ative time. Postoperative imaging assessed ventricular catheter positioning using a grading system. Optimal placement (Grade 1), defined as the catheter tip ending in the ipsilateral frontal horn or third ventricle, was associated with better long-term function and was achieved in the majority of patients. Conclusion: Ultrasound-guided VP shunt is an efficient and safe treatment for idiopathic intracranial hypertension. It improves catheter placement and most patients show clear post-operative improvement, though some may need revision.