术后视敏度:中等质量证据表明,尽管围手术期可能会出现视力丧失,视神经纤维髓鞘开窗术能改善视敏度或视野。[85]Goh KY, Schatz NJ, Glaser JS. Optic nerve sheath fenestration for pseudotumor cerebri. J Neuroophthalmol. 1997 Jun;17(2):86-91.http://www.ncbi.nlm.nih.gov/pubmed/9176777?tool=bestpractice.com[86]Acheson JF, Green WT, Sanders MD. Optic nerve sheath decompression for the treatment of visual failure in chronic raised intracranial pressure. J Neurol Neurosurg Psychiatry. 1994 Nov;57(11):1426-9.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1073203/pdf/jnnpsyc00041-0124.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/7964827?tool=bestpractice.com[87]Kelman SE, Heaps R, Wolf A, et al. Optic nerve decompression surgery improves visual function in patients with pseudotumor cerebri. Neurosurgery. 1992 Mar;30(3):391-5.http://www.ncbi.nlm.nih.gov/pubmed/1620303?tool=bestpractice.com[88]Sergott RC, Savino PJ, Bosley TM. Modified optic nerve sheath decompression provides long-term visual improvement for pseudotumor cerebri. Arch Ophthalmol. 1988 Oct;106(10):1384-90.http://www.ncbi.nlm.nih.gov/pubmed/3178549?tool=bestpractice.com[89]Corbett JJ, Nerad JA, Tse DT, et al. Results of optic nerve sheath fenestration for pseudotumor cerebri: the lateral orbitotomy approach. Arch Ophthalmol. 1988 Oct;106(10):1391-7.http://www.ncbi.nlm.nih.gov/pubmed/3273487?tool=bestpractice.com[90]Plotnik JL, Kosmorsky GS. Operative complications of optic nerve sheath decompression. Ophthalmology. 1993 May;100(5):683-90.http://www.ncbi.nlm.nih.gov/pubmed/8493011?tool=bestpractice.com[91]Brourman ND, Spoor TC, Ramocki JM. Optic nerve sheath decompression for pseudotumor cerebri. Arch Ophthalmol. 1988 Oct;106(10):1378-83.http://www.ncbi.nlm.nih.gov/pubmed/3178548?tool=bestpractice.com[92]Rizzo JF 3rd, Lessell S. Choroidal infarction after optic nerve sheath fenestration. Ophthalmology. 1994 Sep;101(9):1622-6.http://www.ncbi.nlm.nih.gov/pubmed/8090466?tool=bestpractice.com[93]Spoor TC, McHenry JG. Long-term effectiveness of optic nerve sheath decompression for pseudotumor cerebri. Arch Ophthalmol. 1993 May;111(5):632-5.http://www.ncbi.nlm.nih.gov/pubmed/8489443?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
术后视敏度:中等质量证据表明,尽管围手术期可能会出现视力丧失,视神经纤维髓鞘开窗术能改善视敏度或视野。[85]Goh KY, Schatz NJ, Glaser JS. Optic nerve sheath fenestration for pseudotumor cerebri. J Neuroophthalmol. 1997 Jun;17(2):86-91.http://www.ncbi.nlm.nih.gov/pubmed/9176777?tool=bestpractice.com[86]Acheson JF, Green WT, Sanders MD. Optic nerve sheath decompression for the treatment of visual failure in chronic raised intracranial pressure. J Neurol Neurosurg Psychiatry. 1994 Nov;57(11):1426-9.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1073203/pdf/jnnpsyc00041-0124.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/7964827?tool=bestpractice.com[87]Kelman SE, Heaps R, Wolf A, et al. Optic nerve decompression surgery improves visual function in patients with pseudotumor cerebri. Neurosurgery. 1992 Mar;30(3):391-5.http://www.ncbi.nlm.nih.gov/pubmed/1620303?tool=bestpractice.com[88]Sergott RC, Savino PJ, Bosley TM. Modified optic nerve sheath decompression provides long-term visual improvement for pseudotumor cerebri. Arch Ophthalmol. 1988 Oct;106(10):1384-90.http://www.ncbi.nlm.nih.gov/pubmed/3178549?tool=bestpractice.com[89]Corbett JJ, Nerad JA, Tse DT, et al. Results of optic nerve sheath fenestration for pseudotumor cerebri: the lateral orbitotomy approach. Arch Ophthalmol. 1988 Oct;106(10):1391-7.http://www.ncbi.nlm.nih.gov/pubmed/3273487?tool=bestpractice.com[90]Plotnik JL, Kosmorsky GS. Operative complications of optic nerve sheath decompression. Ophthalmology. 1993 May;100(5):683-90.http://www.ncbi.nlm.nih.gov/pubmed/8493011?tool=bestpractice.com[91]Brourman ND, Spoor TC, Ramocki JM. Optic nerve sheath decompression for pseudotumor cerebri. Arch Ophthalmol. 1988 Oct;106(10):1378-83.http://www.ncbi.nlm.nih.gov/pubmed/3178548?tool=bestpractice.com[92]Rizzo JF 3rd, Lessell S. Choroidal infarction after optic nerve sheath fenestration. Ophthalmology. 1994 Sep;101(9):1622-6.http://www.ncbi.nlm.nih.gov/pubmed/8090466?tool=bestpractice.com[93]Spoor TC, McHenry JG. Long-term effectiveness of optic nerve sheath decompression for pseudotumor cerebri. Arch Ophthalmol. 1993 May;111(5):632-5.http://www.ncbi.nlm.nih.gov/pubmed/8489443?tool=bestpractice.com
颅内压改变:低质量证据表明,出现阻塞性睡眠呼吸暂停和视神经乳头水肿的患者,呼吸暂停和动脉血氧饱和度下降会使颅内压升高。[16]Purvin VA, Kawasaki A, Yee RD. Papilledema and obstructive sleep apnea syndrome. Arch Ophthalmol. 2000;118:1626-1630.http://www.ncbi.nlm.nih.gov/pubmed/11115256?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
颅内压改变:低质量证据表明,出现阻塞性睡眠呼吸暂停和视神经乳头水肿的患者,呼吸暂停和动脉血氧饱和度下降会使颅内压升高。[16]Purvin VA, Kawasaki A, Yee RD. Papilledema and obstructive sleep apnea syndrome. Arch Ophthalmol. 2000;118:1626-1630.http://www.ncbi.nlm.nih.gov/pubmed/11115256?tool=bestpractice.com
视力丧失:低质量证据表明,除了生理盲点扩大以外,>90% 的患者至少一只眼睛经 Goldmann 视野测量发现视力丧失,自动视野测量的结果相似。[44]Wall M, George D. Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain. 1991 Feb;114 (pt 1A):155-80.http://www.ncbi.nlm.nih.gov/pubmed/1998880?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
视力丧失:低质量证据表明,除了生理盲点扩大以外,>90% 的患者至少一只眼睛经 Goldmann 视野测量发现视力丧失,自动视野测量的结果相似。[44]Wall M, George D. Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain. 1991 Feb;114 (pt 1A):155-80.http://www.ncbi.nlm.nih.gov/pubmed/1998880?tool=bestpractice.com
视神经乳头水肿缓解:低质量证据表明,给予低能量饮食,限制液体和钠时,视神经乳头水肿会有所好转。[57]Newborg B. Pseudotumor cerebri treated by rice reduction diet. Arch Intern Med. 1974 May;133(5):802-7.http://www.ncbi.nlm.nih.gov/pubmed/4821775?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
视神经乳头水肿缓解:低质量证据表明,给予低能量饮食,限制液体和钠时,视神经乳头水肿会有所好转。[57]Newborg B. Pseudotumor cerebri treated by rice reduction diet. Arch Intern Med. 1974 May;133(5):802-7.http://www.ncbi.nlm.nih.gov/pubmed/4821775?tool=bestpractice.com
症状消退:低质量证据表明,脑脊液 (CSF) 分流术能改善症状,尤其是当患者的主要问题是剧烈头痛时。[80]Eggenberger ER, Miller NR, Vitale S. Lumboperitoneal shunt for the treatment of pseudotumor cerebri. Neurology. 1996 Jun;46(6):1524-30.http://www.ncbi.nlm.nih.gov/pubmed/8649541?tool=bestpractice.com[81]Rosenberg M, Smith C, Beck R, et al. The efficacy of shunting procedures in pseudotumor cerebri (abstract). Neurology. 1989;39(suppl 1):S209.[82]Johnston I, Besser M, Morgan MK. Cerebrospinal fluid diversion in the treatment of benign intracranial hypertension. J Neurosurg. 1988 Aug;69(2):195-202.http://www.ncbi.nlm.nih.gov/pubmed/3392566?tool=bestpractice.com[83]Burgett RA, Purvin VA, Kawasaki A. Lumboperitoneal shunting for pseudotumor cerebri. Neurology. 1997 Sep;49(3):734-9.http://www.ncbi.nlm.nih.gov/pubmed/9305333?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
症状消退:低质量证据表明,脑脊液 (CSF) 分流术能改善症状,尤其是当患者的主要问题是剧烈头痛时。[80]Eggenberger ER, Miller NR, Vitale S. Lumboperitoneal shunt for the treatment of pseudotumor cerebri. Neurology. 1996 Jun;46(6):1524-30.http://www.ncbi.nlm.nih.gov/pubmed/8649541?tool=bestpractice.com[81]Rosenberg M, Smith C, Beck R, et al. The efficacy of shunting procedures in pseudotumor cerebri (abstract). Neurology. 1989;39(suppl 1):S209.[82]Johnston I, Besser M, Morgan MK. Cerebrospinal fluid diversion in the treatment of benign intracranial hypertension. J Neurosurg. 1988 Aug;69(2):195-202.http://www.ncbi.nlm.nih.gov/pubmed/3392566?tool=bestpractice.com[83]Burgett RA, Purvin VA, Kawasaki A. Lumboperitoneal shunting for pseudotumor cerebri. Neurology. 1997 Sep;49(3):734-9.http://www.ncbi.nlm.nih.gov/pubmed/9305333?tool=bestpractice.com
脑脊液 (CSF) 压力:低质量证据表明,腰椎穿刺 82 分钟后,脑脊液压力会恢复到穿刺前的水平。[111]Johnston I, Paterson A. Benign intracranial hypertension - II: CSF pressure and circulation. Brain. 1974 Jun;97(2):301-12.http://www.ncbi.nlm.nih.gov/pubmed/4434179?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
脑脊液 (CSF) 压力:低质量证据表明,腰椎穿刺 82 分钟后,脑脊液压力会恢复到穿刺前的水平。[111]Johnston I, Paterson A. Benign intracranial hypertension - II: CSF pressure and circulation. Brain. 1974 Jun;97(2):301-12.http://www.ncbi.nlm.nih.gov/pubmed/4434179?tool=bestpractice.com
症状改善:低质量证据表明,皮质类固醇能改善症状和体征,但存在不利影响,症状可能会在快速减少后重新出现。[106]Weisberg LA. Benign intracranial hypertension. Medicine (Baltimore). 1975 May;54(3):197-207.http://www.ncbi.nlm.nih.gov/pubmed/1143085?tool=bestpractice.com[112]Weisberg LA, Chutorian AM. Pseudotumor cerebri of childhood. Am J Dis Child. 1977;131:1243-1248.http://www.ncbi.nlm.nih.gov/pubmed/920674?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
症状改善:低质量证据表明,皮质类固醇能改善症状和体征,但存在不利影响,症状可能会在快速减少后重新出现。[106]Weisberg LA. Benign intracranial hypertension. Medicine (Baltimore). 1975 May;54(3):197-207.http://www.ncbi.nlm.nih.gov/pubmed/1143085?tool=bestpractice.com[112]Weisberg LA, Chutorian AM. Pseudotumor cerebri of childhood. Am J Dis Child. 1977;131:1243-1248.http://www.ncbi.nlm.nih.gov/pubmed/920674?tool=bestpractice.com
头痛,视神经乳头水肿:低质量证据表明,给予氯噻酮和螺内酯后加用右旋苯丙胺或苯丁胺或乙酰唑胺后,头痛和视神经乳头水肿在患者中的改善结果不一致。[113]Ahmad S. Amiodarone and reversible benign intracranial hypertension. Cardiology. 1996;87:90.http://www.ncbi.nlm.nih.gov/pubmed/8631054?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
头痛,视神经乳头水肿:低质量证据表明,给予氯噻酮和螺内酯后加用右旋苯丙胺或苯丁胺或乙酰唑胺后,头痛和视神经乳头水肿在患者中的改善结果不一致。[113]Ahmad S. Amiodarone and reversible benign intracranial hypertension. Cardiology. 1996;87:90.http://www.ncbi.nlm.nih.gov/pubmed/8631054?tool=bestpractice.com