Evaluation Of The Cases With Intracranial Hypertension

Abstract

Objective: In this study clinical findings of patients, who diagnosed with IIH in Duzce UnivesityResearch and Teaching Hospital Neurology Clinic were investigated.Materials and Methods: Treatment and follow-up of 23 patients were examined with diagnosisof IIH from the records. The study was based on modified Dandy criteria. The patients whowere performed lumbar puncture and were done cranial imaging included in the study.Results: The patients diagnosed with IIH were 78.3% female and 21.7% male. The mostcommon reason for admission was headache and it was accompanied by blurred vision, visualof limitation, temporary loss of vision, eye pain, double vision, nausea, dislike of light, dizzinessand tinnitus. 60.9% of the patients were obese. Five patients without papilledema were diagnosedwith IIH. The cranial imagings were in normal limits except for empty cella. In treatment, thepatients were given acetozolamide, methylprednisolone and/or topiramate. The follow-up periodwas arranged in 3-6 months. In the process, there were not any patients who had loss of vision.Conclusion: Continuity in atypical cases of headache, if they have obesity, there should befurther examination in mind of an IIH diagnosis. Early diagnosis and treatment are import toprevent the possible loss of vision

Keywords

• Idiopathic intracranial hypertension,pseudotumor cerebri,headache,obesity

İntrakranial Hipertansiyonlu Olguların Değerlendirilmesi

Abstract

Amaç: Düzce Üniversitesi Araştırma ve Uygulama Hastanesi, Nöroloji kliniğinde İHH tanısıkonulmuş hastaların klinik bulgu ve tedavilerinin prognoz ile ilişkilerinin incelenmesiamaçlanmıştır.Gereç ve Yöntem: İİH tanısı ile tedavi ve takip edilen 23 hasta incelendi. Çalışmada ModifiyeDandy Kriterleri esas alındı. Kranial görüntüleme yapılarak, lomber ponksiyonlarıgerçekleştirildi.Bulgular: İİH tanılı hastaların %78,3'si kadın, %21,7 ’si erkekti. En sık başvuru nedeni olanbaş ağrısına, bulanık görme, bakış kısıtlılığı, geçici görme kaybı, göz ağrısı, çift görme, bulantı,ışıktan rahatsız olma, baş dönmesi ve kulak çınlaması eşlik ediyordu. Hastaların %60.9'u obezdi.Beş hastada papil ödem gözlenmeksizin İİH tanısı saptandı.Empty sella dışında kranialgörüntüleme normal sınırlardaydı. Tedavide, asetozolamid, metilprednisolon ve/veya topiramatverildi. Takip süresi 3-6 ay olarak düzenlendi. Bu süreç içinde görme kaybı yaşayan hastamızolmadı.Sonuç: Devamlılık gösteren atipik baş ağrı vakalarında, obezite varsa İİH tanısı düşünülerekileri tetkik yapılmalıdır. Erken tedavi, olası görme kayıplarını önlemede önem taşımaktadır

Keywords

• İdiopatik intrakranial hipertansiyon,psödotümör serebri,başağrısı,obezite

References

1. Wall M. Idiopathic intracranial hypertension. Neurol Clin. 1991;9:73-95.
2. Ivancic R, Pfadenhaur K. Pseudotumor cerebri after hormonal emergency contraception. Eur Neurol. 2004;52:120.
3. Durcan FJ, Corbett JJ, Wall M. The incidence of pseudotumor cerebri. Population studies in Iowa and Louisiana. Arch Neurol. 1988;45:875-7.
4. Dandy W. Intracranial pressure without brain tumor. Ann Surg. 1937;106:492-513.
5. The International Classification of Headache Disorders, 2nd edition. Cephalalgia. 2004;24 (Suppl. 1):9–160.
6. Kesler A, Goldhammer Y, Gadoth N. Do men with idiopathic intracranial pressures share the same characteristics as women? A retrospective review of 141 cases. J. Neuroophthalmol. 2001;21:15–7.
7. Giuseffi V, Wall M, Siegel PZ, Rojas PB. Symptoms and disease associations in idiopathic intracranial hypertension (pseudotumor cerebri): a case-control study. Neurology. 1991;41:239–44.
8. Kansu T. Papiledema and idiopathic intracranial hypertension (pseudotumor cerebri). Turkiye Klinikleri J. Surg. Med. Sci. 2006;2(14): 8-11.

9. Iencean SM. Idiopathic intracranial hypertension and idiopathic normal pressure hydrocephalus: diseases with opposite pathogenesis? Med. Hypotheses. 2003;61:526-8.
10. Wall M, George D. Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain. 1991;114:155–80.
11. Celebisoy N, Seçil Y, Akyürekli O. Pseudotumor cerebri: etiological factors, presenting features and prognosis in the western part of Turkey. Acta Neurol Scand. 2002;106:367-70.
12. Wall M, White WN. Asymmetric papilledema in idiopathic intracranial hypertension: prospective interocular comparison of sensory visual function. Invest. Ophthalmol. Vis. Sci. 1998;39:134–42.
13. Wall M. Idiopathic Intracranial Hypertension. Neurol. Clin. 2010;28:593–617.
14. Curry WT Jr. Butler WE, Barker FG. Rapidly rising incidence of cerebrospinal fluid shunting procedures for idiopathic intracranial hypertension in the United States, 1988-2002. Neurosurgery. 2005;57:97–108.
15. Chandrasekaran S, McCluskey P, Minassian D, Assaad N. Visual outcomes for optic nerve sheath fenestration in pseudotumour cerebri and related conditions. Clin. Experiment. Ophthalmol. 2006;34:661–5.