All patients must have thorough ophthalmologic exams to document the extent of visual deficit. Persistent symptoms or progressive visual deterioration warrants surgical intervention. Serial lumbar punctures, lumboperitoneal shunting, subtemporal decompression, and optic nerve sheath fenestration are procedures done for patients with pseudotumor cerebri. Serial lumbar punctures with CSF drainage is a simple procedure that is indeed effective. This therapeutic maneuver is worthy of clinical trial in patient whose symptoms cannot be controlled by medical management.
Lumboperitoneal shunts treat the intracranial pressure elevation.
Side effects of this procedure include persistent headaches or radiating pain down the legs. Subtemporal decompression is the removal of a small window of bone in the temporal area. This allows more room for the brain. This procedure is effective in controlling the symptoms in some patients. The patients are at risk for post-operative seizures.