Pediatrik popülasyonda sekonder psödotümör serebri: klinik özellikler, tedavi ve prognoz

Abstract

Amaç: Psödotümör serebri sendromu (PTSS), intrakranyal kitle, hidrosefali veya beyin omurilik sıvısı (BOS) bileşiminde anormallikler olmadan yüksek kafa içi basıncı (KİB) ile karakterizedir. İkincil PTSS'de (sPTSS), BOS basıncını artıran bir neden vardır. Bu çalışmanın amacı sPTSS tanısı alan pediatrik hastaların tanı, tedavi ve takiplerinin değerlendirilmesidir. Gereç ve yöntem: Bu çalışma tek merkezli üçüncü basamak bir pediatri hastanesinde gerçekleştirilen retrospektif bir çalışmadır. 2018 ile 2023 yılları arasında üçüncü basamak bir hastanede sPTSS tanısı konan ve PTSS için mevcut tanı kriterlerini karşılayan 1-17 yaş arası hastaları dahil ettik. Olguların şikayetleri, etiyolojisi, oftalmolojik değerlendirmeleri ve tedavi sonuçları değerlendirildi. Bulgular: Çalışmaya PTSS tanısı alan 17 hasta dahil edildi. Ortalama yaş 9,82 (±4,6) idi. Hastaların 9'u (%56,2) erkek, 8'i (%43,7) kadındı. En sık görülen semptomlar 10 hastada (%62,5) baş ağrısı, 6 hastada (%37,5) bulantı/kusma, 5 hastada (%31,2) çift görme idi. Hastaların tamamında papilödem, 7 (%43,7) hastada ise altıncı sinir felci vardı. 3 (%16) hastada nüks görüldü. Üç hastaya ikinci basamak tedavi olarak optik sinir fenestrasyonu uygulandı. Sonuç: Medikal tedaviye yanıt alınamayan durumlarda optik sinir kılıfı fenestrasyonu iyi bir tedavi seçeneği olabilir.

Keywords

• Optik sinir
• psödotümör serebri
• çocuk

Secondary pseudotumor cerebri in the pediatric population: clinical features, treatment, and prognosis

Abstract

Purpose: Pseudotumor cerebri syndrome (PTCS) is characterized by elevated intracranial pressure (ICP) without intracranial mass, hydrocephalus, or abnormalities in cerebrospinal fluid (CSF) composition. In secondary PTCS (sPTCS), there is a reason that increases the CSF pressure. The aim of this study is to evaluate the diagnosis, treatment, and follow-up of pediatric patients diagnosed with sPTCS. Materials and methods: This is a retrospective study conducted in a single-center tertiary pediatric hospital. We included patients aged 1-17 years who were diagnosed with sPTCS in a tertiary hospital between 2018 and 2023 and met the current diagnostic criteria for PTCS. We evaluated the complaints, etiology, ophthalmological evaluations, and treatment results of the cases. Results: Seventeen patients with a diagnosis of PTCS were included in the study. The mean age was 9.82 (±4.6). Of the patients, 9 (56.2%) were male and 8 (43.7%) were female. The most common symptoms were headache in 10 patients (62.5%), nausea/vomiting in 6 patients (37.5%), and double vision in 5 patients (31.2%). All patients had papilledema and 7 (43.7%) patients had sixth nerve palsy. Recurrence was observed in 3 (16%) patients. Optic nerve fenestration was performed in three patients as a second-line treatment. Conclusion: In cases that do not respond to medical treatment, optic nerve sheath fenestration may be a good treatment option.

Keywords

• Optic nerve
• pseudotumor cerebri
• child

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