Expert: John Pilcher, MD - 2/25/2009

Question
Hi,
I am a 32 year old female who is 5'6 and weigh approx 230 .  I have a long history of Pseudotumor Cerebri in which I have a VP Shunt implanted for treatment of that.  MY question is this:
I was curious as to wither you have had any opportunity to treat anyone else with my condition and if the lapband or other weightloss surgery was of any help to their condition.  I have tried everything from diet pills, to diet and eating changes, excercise etc. And although I usually am succesasful at losing I am not good at maintaining the loss.  I have been told via doctors and through research that marked and sustatined weight loss can significantly reduce or minimalize my condition or even cure it (For lack of a better word) and so I was curious as to any experience you may have had with this type of situation, if this type of surgery could be done with the VP shunt implanted still, and where I might look for a doctor in my area to inquire on this, and if this type of surgery is usually successful (person based of course I suppose).  Anything you can tell me about this would be wonderful and so I tthank you in advance for your time and knowledge.

Sioncerely,
Sara Farist

Answer
Ms. Farist,
The success rate for helping (or even resolving) pseudotumor cerebri through weight loss surgery is excellent.  The literature with gastric bypass indicates a better than 70% resolution rate; I am not aware of studies that look at weight loss through Band but our understanding indicates this should have a very good success rate as well.

It is probably OK to do surgery with the VP shunt in place, though there will be some concern about infection of the shunt, especially if the selected procedure is a gastric bypass which always involves some bacteria in the abdomen.

In summary, I would definitely support your finding an experienced bariatric surgeon in your area.  You can go to this website for a surgeon locator:

http://www.surgicalreview.org/locate.aspx

Best of luck!
Dr JP