While idiopathic intracranial hypertension (IIH) is more commonly recognized as a disorder of adults, it affects children of all ages and can have distinctive characteristics when presenting in the prepubertal age group. It is characterized by raised intracranial pressure (ICP) in the absence of brain parenchymal lesion, vascular malformations, hydrocephalus, or central nervous system (CNS) infection. The diagnosis is usually confirmed by a high opening pressure of cerebrospinal fluid (CSF) with exclusion of secondary causes of intracranial hypertension. Objectives: The purpose of this review is to summarize relevant articles on the diagnostic tools used in evaluation and management of pediatric IIH. A summary of demographics, clinical presentation, diagnosis, neuroimaging, as well as existing evidence of treatment strategies is presented. Method: We conducted a bibliographic search in PubMed using the terms idiopathic intracranial hypertension (IIH), Pseudotumor Cerebri syndrome (PTCS). The review of the literature revealed a lack of published consistent data on the diagnosis criteria and management of idiopathic intracranial hypertension in children. Conclusion:This article provides a review of IIH in children and revised diagnostic criteria based on recent evidence and published opinion. Relative to the adult population, the demographic features and clinical presentation of IIH as well as the diagnosis and treatment guidelines for children are quite different. This review highlights the importance of early recognition and management of IIH to prevent permanent visual loss. Key words: idiopathic intracranial hypertension, pseudotumor cerebri syndrome Idiopathic intracranial hypertension (IIH), also referred to as Pseudotumor Cerebri, is characterized by elevated intracranial pressure without discernable etiology, with normal cerebrospinal fluid content, and normal contrast-enhanced computed tomography (CT) or magnetic resonance irradiation (1,2,3).
Adult patients who present with papilloedema and symptoms of raised intracranial pressure need urgent multidisciplinary assessment including neuroimaging, to exclude life-threatening causes. Where there is no apparent underlying cause for the raised intracranial pressure, patients are considered to have idiopathic intracranial hypertension (IIH). Objectives: This review encompasses the newly revised diagnostic criteria for PTCS in adults and children and the role of obesity in the epidemiology, etiology, and management of IIH.Furthermore, this paper tries to offer a practical approach to assessing patients with papilloedema, the investigations and the subsequent management of patients with IIH. Methodology: PubMed was used to search for IIH and Pseudotumor Cerebri. The vast majority of the literature consisted of cohort studies, case control studies, systematic reviews and other narrative reviews. Conclusion: Idiopathic intracranial hypertension (IIH), also known as primary Pseudotumor Cerebri syndrome (PTCS), is a condition of unknown etiology which affects primarily overweight, reproductive-aged women and causes increased intracranial pressure (ICP). This review discusses the recently revised diagnostic criteria for IIH for adults and children and the controversial issues in its diagnosis and management.
Evaluation des modifications structurelles de la tête du nerf optique et de la rétine péri-papillaire par tomographie en cohérence optique dans l'hypertension intracrânienne idiopathique Introduction. Une détection fiable de l'oedème papillaire est une considération essentielle pour établir le diagnostic de l'hypertension intracrânienne idiopathique (HTIC), mais l'examen ophtalmoscopique du fond d'oeil de la tête du nerf optique (ONH) est une mesure subjective limitée par l'expérience de l'examinateur, le degré de la collaboration et l'optique de l'ophtalmoscope, le rendant souvent peu fiable pour détecter un oedème précoce et pour évaluer les améliorations ou aggravations initiales. Le but de l'étude était d'évaluer le rôle de la tomographie par cohérence optique (OCT) dans le diagnostic et la surveillance de l'oedème papillaire produit par IIH.
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