Psödotümör Serebri Sendromu’nda Klinik Özellikler: 60 Hastanın Retrospektif Değerlendirilmesi

Year 2019, Volume: 72 Issue: 1, 61 - 65, 13.06.2019

Yasemin Eren

Abstract

Amaç: Psödotümör serebri sendromu (PTSS) tanısı ile izlenen hastaların demografik, klinik ve radyolojik özelliklerinin değerlendirmektir.

Gereç ve Yöntem: 2014-2018 yılları arasında, baş ağrısı polikliniğinde takip edilen altmış olgunun etiyolojik, semptom, oftalmolojik, radyolojik ve tedavi verileri retrospektif olarak incelendi.

Bulgular: Çalışmaya yaş ortalaması 33,70±9,17 olan 54 kadın, 36,50±12,37 olan 6 erkek hasta alındı. Ortalama hastalık süresi 8,91±12,73 ay ve ortalama vücut kitle indeksi değeri 30,43±5,27 idi. Etiyolojik olarak %73,3’ü primer, %26,7’si sekonder nedenli idi. Hastaların %91,7’nde baş ağrısı, %65’de tinnitus, %16,7’nde diplopi ve tamamında papil ödem vardı. Manyetik rezonans görüntülemede 26 hastada perioptik subaraknoid boşluğun genişlemesi, 3 hastada posterior globda düzleşme, 1 hastada Arnold-Chiari malformasyonu, 9 hastada empty sella izlendi. Tedavide 43 hasta asetozolamid, 13 hasta asetozolamid ve topiramat, 2 hasta asetozolamid,furosemid ve topiramat, 1 hasta topiramat kullandı. Bir hastaya optik sinir fenestrasyonu yapıldı.

Sonuç: Klinik ve nörogörüntüleme bulgularının güncellenmesi, PTSS tanısına daha kapsamlı bir yaklaşım getirmiştir. Ancak PTSS’nun patofizyolojisi halen tam olarak aydınlatılamamıştır. Bu konuda yapılacak araştırmalar, daha etkin tanı ve tedavi yöntemlerinin geliştirilmesini sağlayacaktır.

Keywords

İdiyopatik İntrakraniyal Hipertansiyon, Psödotümör Serebri Sendromu, Baş Ağrısı

Ethical Statement

Çalışma için, Sağlık Bilimleri Üniversitesi, Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu’ndan onay alınmıştır (2018-46/21).

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Clinical Features of Pseudotumour Cerebri Syndrome Syndrome: A Retrospective Evaluation of 60 Patients

Abstract

Objectives: To evaluate the demographic, clinical and radiological characteristics of the patients who are followed up with the diagnosis of pseudotumour cerebri syndrome (PTCS).

Materials and Methods: The etiological, symptomatic, ophtalmologic, radiological and treatment data of sixty cases that were followed up at the outpatient headache clinic between 2014 and 2018 were retrospectively analyzed.

Results: Fifty-four female patients having an average age of (36.50±12.37) and 6 male patients having an average age of (33.70±9.17) were included in the study. Mean disease period was 8.91±12.73 months and mean body mass index value was 30.43±5.27. Etiologically, it was due to primary (73.3%) or secondary (26.7%) causes. Headache was present in 91.7% of the patients, tinnitus in 65%, diplopia in 16.7% and papiloedema was present in all the patients. In magnetic resonance imaging, extension of the perioptic subarachnoid space was observed in 26 patients, flattening in the posterior globe in 3 patients, Arnold-Chiari malformation in 1 patient, and empty sella in 9 patients. In the treatment, 43 patients used acetazolamide, 13 patients used acetazolamide and topiramate, 2 patients used acetazolamide, furosemide and topiramate, and 1 patient used topiramate. Optic nerve fenestration was applied to 1 patient.

Conclusion: Update of the clinical and neuroimaging findings has brought a more detailed approach for the PTCS diagnosis. However, the pathophysiology of PTSS remains unclear. Researches on this regard will enable the development of more effective diagnosis and treatment methods.

Keywords

Idiopathic Intracranial Hypertension, Pseudotumour Cerebri Syndrome, Headache

Ethical Statement

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