Cirurgia Bariátrica como possível tratamento para Pseudotumor cerebri: Caso Clínico

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.