Clinical and Neuroimaging Findings of Pseudotumor Cerebri in Chıildren

Yıl 2018, , 33 - 40, 30.04.2018

Rahşan Göçmen , Bahadır Konuşkan

https://doi.org/10.24938/kutfd.357408

Cited By: 1

Öz

Objective: Pseudotumor cerebri is
characterized by symptoms and signs of elevated intracranial pressure with
normal cerebrospinal fluid composition in the absence of intracranial mass,
structural lesion, hydrocephalus, or meningeal enhancement on neuroimaging.
Although this syndrome most commonly affects female patients at childbearing
age, it is also not rare in men and children. We aimed to review the clinical
and neuroimaging findings in children in the present study.

Material and Methods: The records of the patients who
were diagnosed with pseudotumor cerebri in our pediatric neurology department
between June 2014- November 217 were retrospectively analyzed.

Results: A total of 14 patients diagnosed
with pseudotumor cerebri (7 female, 7 male) were included in the study. The
most common symptom was headache and it was recorded in all of the patients.
Two of the patients had dural venous sinus thrombosis. Brain MRI was performed in 11
patients. Two of these 11 patients had normal imaging findings. Enlargement of subarachnoid space around the optic
nerves was most common imaging findings (64%). All
patients were treated medically. Only one patient in the series required
endoscopic optic sheath fenestration.

Conclusion: It is
shown that the prognosis of pseudotumor cerebri is good provided that early
diagnosis is made and appropriate treatment and follow-up are accomplished.

Anahtar Kelimeler

Pseudotumor cerebri, papilledema, magnetic resonance imaging, headache

ÇOCUKLARDA PSÖDOTÜMÖR SEREBRİNİN KLİNİK VE NÖROGÖRÜNTÜLEME BULGULARI

Öz

Amaç: Psödotümör serebri; kitle, yapısal
lezyon, hidrosefali veya meningial kontrastlanma olmaksızın, normal beyin
omurilik sıvısı içeriği ile birlikte, intrakranial basınç artışının belirti ve
bulgularının olması ile karakterizedir. En sık doğurganlık çağındaki kadınları
etkilemesine rağmen, çocuklar ve erkeklerde de nadir değildir. Bu çalışmanın
amacı, çocuklarda psödotümör serebrinin klinik ve nörogörüntüleme bulgularını
gözden geçirmektir.

Gereç ve Yöntem: Haziran 2014- Kasım 2017 yılları
arasında, çocuk nöroloji kliniğimizde psödotümör serebri tanısı almış hastalar
geriye dönük olarak analiz edilmiştir.

Bulgular: Toplam 14 hasta (7 kız, 7 erkek)
çalışmaya dahil edildi. En sık görülen belirti başağrısı olup, hastaların
tamamında kaydedildi. İki hastada dural venöz sinüs trombozu vardı. On bir
olguya beyin MRG yapıldı. Bu 11 olgunun ikisinde görüntüleme bulguları normal
idi. Optik sinirlerin çevresindeki subraaknoid mesafe genişlemesi en sık
görüntüleme bulgusu idi (%64). Bütün hastalara medikal tedavi verildi.
Olgulardan sadece birisinde endoskopik optik kılıf fenestrasyonu ihtiyacı
doğmuştur.

Sonuç: Mevcut çalışmamızda, erken tanı konulup uygun tedavi ve takip edildiği
taktirde, psödotümör serebrinin prognozunun iyi olduğu gösterilmiştir.

Anahtar Kelimeler

psödotümör serebri, papilödem, manyetik rezonans görüntüleme, başağrısı

Kaynakça

• Spennato P, Ruggiero C, Parlato RS, Buonocore MC, Varone A, Cianciulli E, et al. Pseudotumor cerebri. Childs Nerv Syst. 2011;27:215-35.
• Masri A, Jaafar A, Noman R, Gharaibeh A, Ababneh OH. Intracranial Hypertension in Children: Etiologies, Clinical Features, and Outcome. J Child Neurol. 2015;30(12):1562-8.
• Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology. 2013;81:1159-65.
• Durcan FJ, Corbett JJ, Wall M. The incidence of pseudotumor cerebri. Population studies in Iowa and Louisiana. Arch Neurol. 1988;45(8):875-7.
• Balcer LJ, Liu GT, Forman S, Pun K, Volpe NJ, Galetta SL, et al. Idiopathic intracranial hypertension: relation of age and obesity in children. Neurology. 1999;10;52(4):870-2.
• Görkem SB, Doganay S, Canpolat M, Koc G, Dogan MS, Per H, et al. MR imaging findings in children with pseudotumor cerebri and comparison with healthy controls. Childs Nerv Syst. 2015;31(3):373-80.
• Hartmann AJ, Soares BP, Bruce BB, Saindane AM, Newman NJ, Biousse V, et al. Imaging Features of Idiopathic Intracranial Hypertension in Children. J Child Neurol. 2017; 32(1):120-6.
• Onder H, Gocmen R, Gursoy-Ozdemir Y. Reversible transverse sinus collapse in a patient with idiopathic intracranial hypertension. J Neurointerv Surg. 2016;8(4):e16.
• Ahmed RM, Wilkinson M, Parker GD, Thurtell MJ, Macdonald J, McCluskey PJ, et al. Transverse sinus stenting for idiopathic intracranial hypertension: a review of 52 patients and of model predictions. AJNR. 2011;32(8):1408-14.
• Gospe SM 3rd, Bhatti MT, El-Dairi MA. Anatomic and visual function outcomes in paediatric idiopathic intracranial hypertension. Br J Ophthalmol. 2016;100(4):505-9.
• Değerliyurt A, Teber S, Karakaya G, Güven A, Şeker ED, Arhan EP, et al. Pseudotumor cerebri/idiopathic intracranial hypertension in children: an experience of a tertiary care hospital. Brain Dev. 2014;36(8):690-9.
• Agarwal MR, Yoo JH. Optic nerve sheath fenestration for vision preservation in idiopathic intracranial hypertension. Neurosurg Focus. 2007;23(5):E7.