Idiopathic intracranial hypertension in a paediatric population: a retrospective observational study on epidemiology, symptoms and treatment.
Idiopathic intracranial hypertension (IIH) is a disorder of unknown origin, which is characterized by elevated intracranial pressure (ICP) without underlying etiological evidence of neurological disease. The purpose of the current study was to evaluate epidemiological features, clinical presentation, diagnostic findings and treatment of sixteen children (7 males and 9 females) with IIH. Medical records of the patients were obtained from the University Paediatric Hospital of Catania, Italy. Clinical features, investigations and treatment approaches were retrieved. The mean age of the sixteen children at onset of symptoms was 9 years (range: 4 to 16 years). Most of the patients were classified as pre-pubertal. Mean BMI was 28.9 kg/m2. In 93.75% of patients headache was the presenting clinical symptom; and in the same percentage papilledema was detected as the accompanied sign during diagnostic flow-chart. The mean lumbar puncture opening pressure (LPOP) was 350 mm H2O. Fifty percent of the cases had normal brain imaging, while 12.5% showed enlarged optic nerve diameter and one patient had an intraocular protrusion of the optic nerve on MRI. Two patients (12.5%) had venous sinus stenosis, and one case showed an abnormal spinal MRI. With regard to therapeutic approaches, 93.75% of the cases were successfully treated with Acetazolamide. None of the patients required surgical procedures, and all neuroimaging findings disappeared after receiving treatment. In the present study we investigated the association of IIH with venous sinus stenosis. We also found ocular ultrasound to be a useful non-invasive alternative method for determining papilledema in paediatric IIH, specifically in an emergency.
General Paediatrics O.U., Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Catania, Italy.
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Barbagallo
General Paediatrics O.U., Policlinico-Vittorio Emanuele University Hospital, University of Catania, Italy.
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Vitaliti
General Paediatrics O.U., Policlinico-Vittorio Emanuele University Hospital, University of Catania, Italy.
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Greco
General Paediatrics O.U., Policlinico-Vittorio Emanuele University Hospital, University of Catania, Italy.
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Pavone
Tehran University of Medical Sciences, Tehran, Iran; 4Pediatric Nephrology O.U., La Sapienza University of Rome, Rome, Italy.
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Matin
General Paediatrics O.U., Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Catania, Italy.
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Panta
Pediatric Nephrology O.U., La Sapienza University of Rome, Rome, Italy.
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Lubrano
General Paediatrics O.U., Policlinico-Vittorio Emanuele University Hospital, University of Catania, Italy.
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Falsaperla
D000086:Acetazolamide / Q000627:therapeutic use; D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D003392:Cranial Sinuses / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D005260:Female; D006261:Headache / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D019586:Intracranial Hypertension / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging; D009900:Optic Nerve / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D010211:Papilledema / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies; D013129:Spinal Puncture; D016896:Treatment Outcome
D000927:Anticonvulsants; D000086:Acetazolamide