Pediatric Intracranial Hypertension: a Current Literature Review

Aylward, Shawn C.; Way, Amanda

doi:10.1007/s11916-018-0665-9

Cited by 34 publications

(53 citation statements)

References 85 publications

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“…Previous studies have reported an IH recurrence rate in children of up to 18-22%. 31,32 Although visual loss in pediatric patients with IH has been previously reported, permanent vision loss in is usually rare. 31 In our study, most patients did not have any signs or symptoms of visual deterioration.…”

Section: Results a Total Of 53 Children With Ih Werementioning

confidence: 99%

Pediatric intracranial hypertension

Bashiri

Abdulsalam

Hassan

et al. 2019

NSJ

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Objectives: To review the experience of 2 tertiary centers in Saudi Arabia with intracranial hypertension)IH(in the pediatric population. Methods: We retrospectively reviewed and analyzed pediatric patients diagnosed with IH from June 2002 to May 2017 in 2 institutes. Original Articles Results: We identified 53 patients)30 females and 23 males(with a mean age of 7 years at the time of presentation. Among them, 41 patients were younger than 12 years, and 12 were older. Obese and overweight patients constituted 27.00%)n = 14(of all cases, 8)66.7%(of whom were older than 12 years. The most common presenting feature was papilledema followed by headache. Vitamin D deficiency, which constituted the most common associated condition, was identified in 12)22.6%(patients. Acetazolamide was the treatment option in 98.11% of patients, and only 5.7% underwent surgical interventions. The length of follow-up ranged from 6 months to 8 years. Conclusion: Intracranial hypertension is rare in children and commonly seen in overweight females older than 12 years similar to adults. Patients younger than 12 years tend to develop secondary IH. More studies are needed to characterize the clinical presentation and guide the management plan.

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Section: Results a Total Of 53 Children With Ih Werementioning

confidence: 99%

Pediatric intracranial hypertension

Bashiri

Abdulsalam

Hassan

et al. 2019

NSJ

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“…Besides, it was specified that photophobia and phonophobia accompanied headache symptoms of the patients by 70% and 52%, respectively. Fifty percent of patients' complaints increase with routine physical activity 16 . In our study, the most common complaints for application were headache (51.8%), diplopia (22.2%) and blurred vision (7.4%).…”

Section: Discussionmentioning

confidence: 99%

Çocuklarda psödotümör serebri: etyoloji, klinik bulgular, prognoz

Mert¹,

Özcan²,

Beşen³

et al. 2019

Cukurova Medical Journal

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Öz Purpose: Clinical and neuroimaging findings, aetiologies, treatment modalities and durations, response to treatment, and neurological sequelae of the patients diagnosed with pseudotumor cerebri were reviewed. Materials and Methods: A total of 27 patients who followed up in the Department of Pediatric Neurology at Çukurova Medical Faculty between June 2015 and May 2018 were included in this study. Age, gender distribution, anthropometric measurements, cerebrospinal fluid pressures, neurological, ophthalmologic, neuroimaging and neurological sequelae findings, treatment modalities and durations, response to therapy of 27 patients were reviewed retrospectively. Results: Mean cerebrospinal fluid pressure was 43.29.1cmH2O. The most frequent cause in aetiology were obesity (33.3%), iron deficiency anemia (18.5%) and venous sinus thrombosis (14.8%). All patients were treated with acetazolamid, 59.3% patients received only acetazolamid and 25.9% of patients received combined therapy with acetazolamide and topiramate and 14.8% of patients received combined therapy with acetazolamide and steroids. Of the patients, 25 had excellent neurological and ophtalmological outcome with medical treatment. Conclusion: The most frequently-seen neurological sequelae in pseudotumor cerebri is permanent visual impairment This irreversible situation affects the whole life of child. Therefore it is quite important to think about the diagnosis of pseudotumor cerebri for the children with complaints of headache, visual impairment and diplopia, and to subject them to treatment quickly and properly. Amaç: Psödotümör serebri tanısı alan hastaların klinik ve nörogörüntüleme bulguları, etiyolojileri, tedavi şekilleri ve süreleri, tedaviye yanıtları ve nörolojik sekel varlıkları gözden geçirildi Gereç ve Yöntem: Çalışmaya dahil edilen hastalar Haziran 2015 ile Mayıs 2018 arasında Çukurova Tıp Fakültesi Çocuk Nöroloji Bilim Dalında takip edildi. Yirmi yedi hastanın yaş, cinsiyet dağılımı, antropometrik ölçümleri, BOS basınçları, nörolojik, oftalmolojik, nörogörüntüleme, nörolojik sekel bulguları, tedavi modaliteleri ve süreleri, tedavi yanıtı retrospektif olarak incelendi. Bulgular: BOS basıncı ortalaması 43,29,1cmH2O idi. Etiyolojide en sık neden obezite (%33,3), demir eksikliği anemisi (%18,5) ve venöz sinüs trombozu (%14,8) idi. Hastaların %59,3'üne yalnızca asetazolamid tedavisi verildi, %25,9'una topiramat eklendi, %14,8'ine steroid verildi. 25 hastanın nörolojik ve oftalmolojik bulgularında medikal tedavi ile tamamen düzelme görüldü. Sonuç: Psödotümör serebri hastalığında en sık oluşan nörolojik sekel kalıcı görme kaybıdır. Bu durum geri dönüşümsüz olur ve çocuğun tüm hayatını etkiler. Bu nedenle başağrısı, görme kaybı, çift görme şikayetleri olan çocuklarda Psödotümör serebri tanısının düşünülmesi gerektiğinin bilinmesi ve çocukların hızlı ve uygun şekilde tedavisi prognozda oldukça önemlidir.

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“…6 In both pregnant women and pediatric intracranial hypertensive populations, ACZ is used in doses exceeding 2,000 mg/day to treat intracranial hypertension. 7,8 We chose to test ACZ at 15 mg q.d., a highly subtherapeutic dose, which yields plasma concentrations that are easily detectable using standard analytical methods. The previous University of Kentucky (UKY) study demonstrated the plasma and urinary pharmacokinetics of subtherapeutic ACZ doses had high intersubject reproducibility 4 and was unaffected by a concomitant medication (oxycodone).…”

Section: Articlementioning

confidence: 99%

Subtherapeutic Acetazolamide Doses as a Noninvasive Method for Assessing Medication Adherence

Hampson

Schroeder

Ellefsen

et al. 2020

Clin Pharma and Therapeutics

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Adherence monitoring is a vital component of clinical efficacy trials, as the regularity of medication consumption affects both efficacy and adverse effect profiles. Pill‐counts do not confirm consumption, and invasive plasma assessments can only assist post hoc assessments. We previously reported on the pharmacokinetics of a potential adherence marker to noninvasively monitor dosage consumption during a trial without breaking a blind. We reported that consumption cessation of subtherapeutic 15 mg acetazolamide (ACZ) doses showed a predictable urinary excretion decay that was quantifiable for an extended period. The current study describes the clinical implementation of 15 mg ACZ doses as an adherence marker excipient in distinct cohorts taking ACZ for different “adherence” durations. We confirm that ACZ output did not change (accumulate) during 18–20 days of adherence, and developed and assessed urinary cutoffs as nonadherence indicators. We demonstrate that whereas an absolute concentration cutoff (989 ng/mL) lacked sensitivity, a creatinine normalized equivalent (1,376 ng/mg ACZ) was highly accurate at detecting nonadherence. We also demonstrate that during nonadherent phases of three trials, creatinine‐normalized urinary ACZ elimination was reproducible within and across trials with low variability. Excretion was first order, with a decay half‐life averaging ~ 2.0 days. Further, excretion remained quantifiable for 14 days, providing a long period during which the date of last consumption might be determined. We conclude that inclusion of 15 mg ACZ as a dosage form adherence marker excipient, provides a reliable and sensitive mechanism to confirm medication consumption and detect nonadherence during clinical efficacy trials.

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Pediatric Intracranial Hypertension: a Current Literature Review

Cited by 34 publications

References 85 publications

Pediatric intracranial hypertension

Pediatric intracranial hypertension

Çocuklarda psödotümör serebri: etyoloji, klinik bulgular, prognoz

Subtherapeutic Acetazolamide Doses as a Noninvasive Method for Assessing Medication Adherence

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