Cranial morcellation decompression for refractory idiopathic intracranial hypertension in children

Ballestero, Matheus Fernando Manzolli; Teixeira, Thiago Afonso; Augusto, Lucas Pires; Souza, Stephanie Naomi Funo de; Santos, Marcelo Volpon; Oliveira, Ricardo Santos de

doi:10.1007/s00381-018-3766-1

Cited by 2 publications

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“…Females, especially obese females, are more susceptible to IIH when they are of reproductive age. IIH is rare in children [5,6]. The precise pathophysiology of IIH is unknown and is mainly related to a decrease in CSF drainage, a decrease in CSF absorption, and/or an increase in venous sinus pressure [7].…”

Section: Introductionmentioning

confidence: 99%

“Benign intracranial hypertension” is a misleading name for a more serious disease: analysis of the visual outcome in cases with idiopathic intracranial hypertension

et al. 2019

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Objective: Assessment of visual field outcomes following the medical or surgical management of increased intracranial pressure in patients with idiopathic intracranial hypertension. Patient and methods: Thirty-two patients diagnosed with idiopathic intracranial hypertension who met all the modified Dandy criteria were included in this study. Magnetic resonance brain imaging with contrast and magnetic resonance venography were performed to exclude the presence of secondary causes of intracranial hypertension. Following normal neuroimaging, a lumbar puncture was performed for all patients with papilledema to measure the cerebrospinal fluid opening pressure. The assessment of visual function, including visual acuity, fundus examination (dilated fundus examination to confirm the presence and the grade of papilledema and to exclude the other ocular causes of optic disc swelling), and formal visual field assessment by perimetry when visual acuity was more than 1/60 were performed by the ophthalmologist before and after medical or surgical treatment. Results: Thirty-two patients were included, the majority of whom were females of childbearing age (29/32; 90.6%). All patients complained of headache. Visual assessment revealed the presence of blurry vision in all patients. Papilledema with different grades was observed in 31/32 (96.9%) patients, while the other patient (3.1%) showed optic atrophy; 30/ 32 (93.8%) patients had visual acuity ˃ 1/60. The average visual field was − 18 dB ± 9.97 SD in the right eye and − 19.47 dB ± 5.43 SD in the left eye. Twenty-nine patients received medical treatment in the form of acetazolamide, which succeeded in controlling idiopathic intracranial hypertension in 24/29 (82.7%) patients, while a theco-peritoneal shunt was inserted in 8/32 (25%) patients. After management, statistically significant improvements in cerebrospinal fluid opening pressure, presenting manifestation, visual acuity, and field were noticed. Conclusions: Permanent visual loss is the most feared complication of idiopathic intracranial hypertension; therefore, early diagnosis and multidisciplinary treatment are necessary to improve visual acuity and visual field.

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Section: Introductionmentioning

confidence: 99%

“Benign intracranial hypertension” is a misleading name for a more serious disease: analysis of the visual outcome in cases with idiopathic intracranial hypertension

et al. 2019

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Cranial decompression and expansion surgery for the treatment of refractory idiopathic intracranial hypertension: case report and systematic review

Klieverik

Han

Woerdeman

2021

British Journal of Neurosurgery

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Cranial morcellation decompression for refractory idiopathic intracranial hypertension in children

Abstract: CMD surgery is a safe and effective option to control refractory PIIH in selected patients.

Cited by 2 publications

References 47 publications

“Benign intracranial hypertension” is a misleading name for a more serious disease: analysis of the visual outcome in cases with idiopathic intracranial hypertension

“Benign intracranial hypertension” is a misleading name for a more serious disease: analysis of the visual outcome in cases with idiopathic intracranial hypertension

Cranial decompression and expansion surgery for the treatment of refractory idiopathic intracranial hypertension: case report and systematic review

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