title: [Idiopathic intracranial hypertension: Experience over 25 years and a management protocol].
abstract: BACKGROUND
  We present our experience on idiopathic intracranial hypertension (IIH), before and after the introduction of a specific diagnosis and management protocol.
  
  
  METHODS
  A descriptive retrospective study was conducted on patients with IIH over a 25year period (1990-2015), comparing the last 7years (after introduction of the protocol) with the previous 18years.
  
  
  RESULTS
  Among the 18,865 patients evaluated, there were 54 cases of IIH (29 infants and 25 children). A comparison was made between the two time periods: 32 cases in 1990-2008 -published in An Pediatr (Barc). 2009;71:400-6-, and 23 cases in 2008-2015. In post-protocol period, there were 13 patients aged between 3-10months (62% males) with transient bulging fontanelle, and 10 aged between 2-14years (50% males), with papilloedema. A total of 54% of infants had recently finished corticosteroid treatment for bronchitis. In the older children, there was one case associated with venous thrombosis caused by otomastoiditis, one case on corticosteroid treatment for angioma, and another case treated with growth hormone. Transfontanelle ultrasound was performed on all infants, and CT, MRI and angio-MRI was performed on every child. Lumbar puncture was performed on 2 infants in whom meningitis was suspected, and in all children. All patients progressed favourably, with treatment being started in 3 of them. One patient relapsed.
  
  
  CONCLUSIONS
  Characteristics and outcomes of patients overlap every year. IIH usually has a favourable outcome, although it may be longer in children than in infants. It can cause serious visual disturbances, so close ophthalmological control is necessary. The protocol is useful to ease diagnostic decisions, monitoring, and treatment.
authors.affiliation: Unidad de Neuropediatría, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España. Electronic address: pediatriazaragoza@hotmail.com.
authors.forename: Lorena
authors.initials: L
authors.lastname: Monge Galindo
authors.affiliation: Unidad de Neuropediatría, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España.
authors.forename: Ruth
authors.initials: R
authors.lastname: Fernando Martínez
authors.affiliation: Unidad de Neuropediatría, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Fuertes Rodrigo
authors.affiliation: Servicio de Neurocirugía, Hospital Infantil Universitario Miguel Servet, Zaragoza, España.
authors.forename: David
authors.initials: D
authors.lastname: Fustero de Miguel
authors.affiliation: Servicio de Oftalmología, Hospital Infantil Universitario Miguel Servet, Zaragoza, España.
authors.forename: Victoria
authors.initials: V
authors.lastname: Pueyo Royo
authors.affiliation: Unidad de Neuropediatría, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: García Iñiguez
authors.affiliation: Unidad de Neuropediatría, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España.
authors.forename: Javier
authors.initials: J
authors.lastname: López-Pisón
authors.affiliation: Unidad de Neuropediatría, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Peña-Segura
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011559:Pseudotumor Cerebri / Q000175:diagnosis* / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors
keywords: Child; Fontanela; Fontanelle; Hipertensión intracraneal idiopática; Idiopathic intracranial hypertension; Niños; Papiledema; Papilloedema; Protocol; Protocolo; Pseudotumor cerebri; Pseudotumour cerebri