Pseudotumor cerebri in children: etiology, clinical findings, prognosis
Abstract
Purpose: Clinical and neuroimaging findings, aetiologies, treatment modalities and durations, response to treatment, and neurological sequelae of the patients diagnosed with pseudotumor cerebri were reviewed.
Materials and Methods: A total of 27 patients who followed up in the Department of Pediatric Neurology at Çukurova Medical Faculty between June 2015 and May 2018 were included in this study. Age, gender distribution, anthropometric measurements, cerebrospinal fluid pressures, neurological, ophthalmologic, neuroimaging and neurological sequelae findings, treatment modalities and durations, response to therapy of 27 patients were reviewed retrospectively.
Results: Mean cerebrospinal fluid pressure was 43.29.1cmH2O. The most frequent cause in aetiology were obesity (33.3%), iron deficiency anemia (18.5%) and venous sinus thrombosis (14.8%). All patients were treated with acetazolamid, 59.3% patients received only acetazolamid and 25.9% of patients received combined therapy with acetazolamide and topiramate and 14.8% of patients received combined therapy with acetazolamide and steroids. Of the patients, 25 had excellent neurological and ophtalmological outcome with medical treatment. Conclusion: The most frequently-seen neurological sequelae in pseudotumor cerebri is permanent visual impairment This irreversible situation affects the whole life of child. Therefore it is quite important to think about the diagnosis of pseudotumor cerebri for the children with complaints of headache, visual impairment and diplopia, and to subject them to treatment quickly and properly.
Keywords
Idiopathic intracranial hypertension , papillae edema , headache , childhood
Kaynakça
- 1) Digre KB, Bruce BB, McDermott MP, et al. Quality of life in idiopathic intracranial hypertension at diagnosis: IIH Treatment Trial results. Neurology 2015;84:2449
- 2) Dessardo NS, Dessardo S, Sasso A, Sarunic AV, Dezulovic MS. Pediatric idiopathic intracranial hypertension: clinical and demographic features. Coll Antropol. 2010;34(Suppl 2):217–21.
- 3) Aylward SC, Waslo SC, Johnathan N, Tanne E. Manifestations of Pediatric Intracranial Hypertension from the Intracranial Hypertension Registry. Ped Neurol 2016; 1-7.
- 4) Gillson N, Jones C, Reem RE, Rogers DL, Zumberge N, Aylward SC. Incidence and demographics of pediatric intracranial hypertension. Pediatr Neurol. 2017;73:42–7. https://doi.org/10.1016/j.pediatrneurol.2017.04.021
- 5) Parunyou Julayanont, Amputch Karukote, Doungporn Ruthirago, et al. Idiopathic intracranial hypertension: Ongoing clinical challenges and future prospects. Journal of Pain Research 2016;9: 87–99
- 6) Corbett JJ, Savino PJ, Thompson HS, Kansu T, Schatz NJ, Orr LS, et al. Visual loss in pseudotumor cerebri. Follow-up of 57 patients from five to 41 years and a profile of 14 patients with permanent severe visual loss. Arch Neurol. 1982;39(8):461–74. https://doi.org/10.1001/archneur.1982.00510200003001. 7) Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 2013;81:1159-1165.
- 8) McGeeney BE, Friedman DI. Pseudotumor cerebri pathophysiology. Headache 2014;54:445-458.
- 9) Hainline C, Rucker JC, Balcer LJ. Current concepts in pseudotumor cerebri. Curr Opin Neurol 2016;29:84-93.
- 10) Paley GL, Sheldon CA, Burrows EK, Chilutti MR, Liu GT, McCormack SE. Overweight and obesity in pediatric secondary pseudotumor cerebri syndrome. Am J Ophthalmol 2015;159:344-352.
- 11) Amira Masri, Amani Jaafar, Rasha Noman, et al. Intracranial Hypertension in Children: Etiologies, Clinical Features, and Outcome. Journal of Child Neurology 2015, Vol. 30(12) 1562-1568.
