Novel Magnetic Resonance Imaging Findings in Children With Intracranial Hypertension

Hırfanoğlu, Tuğba; Aydın, Kürşad; Serdaroğlu, Ayşe; Havalı, Cengiz

doi:10.1016/j.pediatrneurol.2015.03.028

Cited by 28 publications

(14 citation statements)

References 32 publications

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“…A study by Hirfanoglu et al included several children who did not meet the most recent criteria for idiopathic intracranial hypertension, which we did not consider in the ranges below. 20 Neither Lim nor Görkem assessed subgroups based on patient age or pubertal status. When comparing the frequencies of imaging findings of all of our children to the previously reported rates in children, 12,13 we found substantially higher occurrences of optic nerve head protrusion (77% vs 17%-40%), posterior scleral flattening (81% vs 56%-61%), and a moderately higher frequency of sellar changes (73% vs 30%-64%).…”

Section: Discussionmentioning

confidence: 99%

Imaging Features of Idiopathic Intracranial Hypertension in Children

et al. 2016

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Magnetic resonance imaging (MRI) signs of elevated intracranial pressure and idiopathic intracranial hypertension have been well characterized in adults but not in children. The MRIs of 50 children with idiopathic intracranial hypertension and 46 adults with idiopathic intracranial hypertension were reviewed for optic nerve head protrusion, optic nerve head enhancement, posterior scleral flattening, increased perioptic cerebrospinal fluid, optic nerve tortuosity, empty or partially empty sella, tonsillar herniation, enlargement of Meckel's cave meningoceles, and transverse venous sinus stenosis(TSS). Compared to adolescents (11-17 years, n = 40) and adults (>17 years, n = 46), prepubescent children (<11 years, n = 10) had lower frequencies of scleral flattening (50% vs 89% and 85%, P = .02), increased perioptic cerebrospinal fluid (60% vs 84% and 89%, P = .08), optic nerve tortuosity (20% vs 46% and 59%, P = .07), empty or partially empty sella (56% vs 78% and 93%, P = .007), and TSS (67% vs 93% and 96%, P = .04). Children with idiopathic intracranial hypertension have similar MRI findings as adults, but they are less frequent in prepubescent children.

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Section: Discussionmentioning

confidence: 99%

Imaging Features of Idiopathic Intracranial Hypertension in Children

et al. 2016

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“…Flattened posterior globes, partially empty sella, and intraocular protrusion, as well as enlargement with tortuosity of the optic nerves are typical findings in idiopathic intracranial hypertension but absence of those features does not exclude the diagnosis. [12][13][14][15]…”

Section: Diagnosismentioning

confidence: 99%

Infantile Idiopathic Intracranial Hypertension: A Case Study and Review of the Literature

et al. 2019

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Idiopathic intracranial hypertension, or pseudotumor cerebri, is an increase in cerebrospinal fluid pressure of unknown etiology. It is mostly seen in adults, less frequently in adolescents, rarely in younger children. Only 5 infants meeting idiopathic intracranial hypertension criteria have been mentioned in the literature. We report a case of a previously healthy 9-month-old boy who presented with irritability, decreased appetite, and a bulging fontanelle. Computed tomography (CT) head imaging and cerebrospinal fluid studies revealed normal results. The patient’s symptoms transiently resolved after the initial lumbar puncture, but 11 days later, his fontanelle bulged again. A second lumbar puncture revealed an elevated opening pressure of 35 cmH2O and led to a diagnosis of idiopathic intracranial hypertension in accordance with the modified Dandy Criteria. Treatment with acetazolamide at a dose of 25 mg/kg/d was initiated and the patient remained symptom-free for 6 weeks, followed by another relapse. His acetazolamide dose was increased to 37 mg/kg/d, with no further relapses to date. A diagnosis of idiopathic intracranial hypertension is challenging in infants, because the patients cannot yet verbalize typical idiopathic intracranial hypertension–related symptoms such as positional headaches, diplopia, or pulsatile tinnitus. Furthermore, it is more difficult to assess papilledema in that age group. If undetected and untreated, idiopathic intracranial hypertension may result in permanent visual deficits. Little is known about idiopathic intracranial hypertension in infants, and age-specific treatment guidelines are lacking. We discuss this rare case of infantile idiopathic intracranial hypertension and provide a review of the literature, including an overview of disease characteristics and outcomes of idiopathic intracranial hypertension in this very young age group.

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“…A comparison of MRI to CT in measuring ONSD suggest that measurements should be in close agreement across both modalities and, indeed, Hirfanoglu et al have recently demonstrated this potential correlation for children ( 31 ).…”

Section: Radiological Parametersmentioning

confidence: 89%

Radiological Correlates of Raised Intracranial Pressure in Children: A Review

et al. 2018

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Radiological assessment of the head is a routine part of the management of traumatic brain injury. This assessment can help to determine the requirement for invasive intracranial pressure (ICP) monitoring. The radiological correlates of elevated ICP have been widely studied in adults but far fewer specific pediatric studies have been conducted. There is, however, growing evidence that there are important differences in the radiological presentations of elevated ICP between children and adults; a reflection of the anatomical and physiological differences, as well as a difference in the pathophysiology of brain injury in children. Here in, we review the radiological parameters that correspond with increased ICP in children that have been described in the literature. We then describe the future directions of this work and our recommendations in order to develop non-invasive and radiological markers of raised ICP in children.

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Novel Magnetic Resonance Imaging Findings in Children With Intracranial Hypertension

Cited by 28 publications

References 32 publications

Imaging Features of Idiopathic Intracranial Hypertension in Children

Imaging Features of Idiopathic Intracranial Hypertension in Children

Infantile Idiopathic Intracranial Hypertension: A Case Study and Review of the Literature

Radiological Correlates of Raised Intracranial Pressure in Children: A Review

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