Manifestations of Pediatric Intracranial Hypertension From the Intracranial Hypertension Registry

Aylward, Shawn C.; Waslo, Carin S.; Au, Johnathan N.; Tanne, Emanuel

doi:10.1016/j.pediatrneurol.2016.04.007

Cited by 54 publications

(58 citation statements)

References 42 publications

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“…Some of these differences could be due to the use of different diagnostic criteria for PTCS. For example, when papilledema was required for the diagnosis of PTCS, the reported prevalence of headache was lower than when it was not required . While intracranial pressure has not clearly correlated with headache severity in both experimental and observational studies of adults, the fact that the absence of headache in PTCS was more frequently encountered in the setting of normal rather than elevated opening pressure in our study suggests that intracranial hypertension plays at least a partial role in the pathogenesis of headache in PTCS.…”

Section: Discussioncontrasting

confidence: 66%

“…For example, when papilledema was required for the diagnosis of PTCS, the reported prevalence of headache was lower 1-3 than when it was not required. [4][5][6][7] While intracranial pressure has not clearly correlated with headache severity in both experimental and observational studies of adults, 22,26 the fact that the absence of headache in PTCS was more frequently encountered in the setting of normal rather than elevated opening pressure in our study suggests that intracranial hypertension plays at least a partial role in the pathogenesis of headache in PTCS. Alternatively, the absence of both headache and intracranial hypertension in a subset of the probable PTCS group is similar to other studies, 27 and raises questions regarding the diagnostic accuracy of papilledema vs pseudopapilledema in these patients.…”

Section: Discussioncontrasting

confidence: 51%

“…Headache is the most common symptom of the pseudotumor cerebri syndrome (PTCS), occurring in 63-98% of both pediatric [1][2][3][4][5][6][7] and adult 8 patients. Headaches attributed to increased intracranial pressure are classically thought to be constant and/ or daily, worsened with recumbence, on awakening, and Valsalva maneuvers, and associated with visual symptoms and pulsatile tinnitus.…”

Section: Introductionmentioning

confidence: 99%

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Headache Characteristics in Children With Pseudotumor Cerebri Syndrome, Elevated Opening Pressure Without Papilledema, and Normal Opening Pressure: A Retrospective Cohort Study

et al. 2018

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Section: Discussioncontrasting

confidence: 66%

Section: Discussioncontrasting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

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Headache Characteristics in Children With Pseudotumor Cerebri Syndrome, Elevated Opening Pressure Without Papilledema, and Normal Opening Pressure: A Retrospective Cohort Study

et al. 2018

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“…Additionally, possible other causes of intracranial hypertension such as cerebral venous abnormalities, relevant medication intake, thyroid disease, anemia, and renal failure have been excluded [2, 10]. Moreover, our patient was an obese woman fulfilling the expected profile for IIH [6, 8]. …”

Section: Discussionmentioning

confidence: 99%

“…Typical symptoms include headache and transient visual loss, which occurs in 85–90% of the cases, followed by tinnitus, diplopia, and rarely no symptoms [6, 7]. Family history of IIH has been reported in only a few cases [8]. Additionally, IIH has been linked to certain medical conditions such as polycystic ovary syndrome [9].…”

Section: Introductionmentioning

confidence: 99%

Uncommon Presentation of Idiopathic Intracranial Hypertension in a Patient with Polycystic Ovary Syndrome: A Case Report

Albarrak

Kojan

2017

Case Rep Neurol

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Introduction: Idiopathic intracranial hypertension is a rare condition characterized by increased intracranial pressure without clinical, laboratory, or radiological evidence of intracranial pathology. Early management could prevent irreversible outcomes. Case Presentation: A 17-year-old single Arabian female of Arab origin presented with a 2-day complaint of horizontal diplopia and transient visual obscurations. She denied any history of headache or decreased vision. The patient was diagnosed with polycystic ovary syndrome a year prior to presentation. Examination revealed bilateral moderate papilledema and limited left eye abduction. However, visual acuity and fields were normal. Increased intracranial pressure was confirmed by lumbar puncture opening pressure (550 mm H₂O). The cerebrospinal fluid composition and imaging of brain and cerebral venous system were normal. The diagnosis of idiopathic intracranial hypertension was confirmed and the patient was treated with acetazolamide 500 mg twice per day. The symptoms totally resolved within 3 days and the papilledema disappeared after 2 months. Conclusion: Awareness of such uncommon presentation of idiopathic intracranial hypertension emphasizes the critical importance of detailed ophthalmic examination and shows the good prognosis of early management.

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Pediatric intracranial hypertension: A review of presenting symptoms, quality of life, and secondary causes

Varma,

Aylward

2024

Annals of the Child Neurology Society

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Our understanding of primary (idiopathic) intracranial hypertension has evolved in recent years. There have been efforts to rename the disorder as pseudotumor cerebri syndrome or primary intracranial hypertension. Some studies have suggested a higher threshold opening pressure to define intracranial hypertension. The reported annual incidence varies from 0.6 to 0.9 per 100 000 children around the world. Patients are typically divided into prepubertal and pubertal groups, with pubertal patients having the same risk factors as adults. Prepubertal patients do not share these risk factors. They are more likely to be asymptomatic, have equal gender distributions, and are less likely to be obese. Headache is the most common presenting complaint, followed by vision changes and nausea/vomiting. A newer concept of fulminant intracranial hypertension has emerged, defined as acute onset with rapid progression of visual deficits or papilledema. Quick insertion of a temporary lumbar drain as a bridge while medical management reaches effectiveness improves visual outcomes and helps avoid permanent shunt placement. Headache is typically the first symptom to resolve with treatment, and papilledema resolves in five to six months. Recurrence rates in children and adolescents range from 28.5% to 36.4%, with higher rates after puberty.

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Manifestations of Pediatric Intracranial Hypertension From the Intracranial Hypertension Registry

Cited by 54 publications

References 42 publications

Headache Characteristics in Children With Pseudotumor Cerebri Syndrome, Elevated Opening Pressure Without Papilledema, and Normal Opening Pressure: A Retrospective Cohort Study

Headache Characteristics in Children With Pseudotumor Cerebri Syndrome, Elevated Opening Pressure Without Papilledema, and Normal Opening Pressure: A Retrospective Cohort Study

Uncommon Presentation of Idiopathic Intracranial Hypertension in a Patient with Polycystic Ovary Syndrome: A Case Report

Pediatric intracranial hypertension: A review of presenting symptoms, quality of life, and secondary causes

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