Idiopathic intracranial hypertension in a paediatric population: a retrospective observational study on epidemiology, symptoms and treatment.
Idiopathic intracranial hypertension in a paediatric population: a retrospective observational study on epidemiology, symptoms and treatment.
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发表时间：
2017
影响因子：
3.2
通讯作者：
M. Barbagallo;G. Vitaliti;F. Greco;P. Pavone;N. Matin;G. Panta;R. Lubrano;R. Falsaperla
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文献类型：
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作者：
M. Barbagallo;G. Vitaliti;F. Greco;P. Pavone;N. Matin;G. Panta;R. Lubrano;R. Falsaperla
特发性颅内压增高（IIH）是一种病因不明的疾病，其特征是颅内压升高，但无神经系统疾病的潜在病因证据。本研究的目的是评估16名IIH儿童（7男9女）的流行病学特征、临床表现、诊断结果和治疗。患者的医疗记录来自意大利卡塔尼亚大学儿科医院。检索临床特征、检查和治疗方法。16名儿童出现症状时的平均年龄为9岁（范围：4至16岁）。大多数患者被归类为青春期前。平均BMI为28.9 kg/m2。93.75%的患者以头痛为主要临床症状，93.75%的患者以视乳头水肿为诊断流程图中的伴随体征。平均腰椎穿刺开口压（LPOP）为350 mm H2O。50%的患者脑部影像学正常，12.5%的患者视神经直径增大，1例患者在MRI上有视神经眼内突出。2例患者（12.5%）有静脉窦狭窄，1例患者显示脊柱MRI异常。在治疗方法方面，93.75%的病例用乙酰唑胺成功治疗。所有患者均无需手术，所有神经影像学检查结果均在接受治疗后消失。在本研究中，我们调查了IIH与静脉窦狭窄的关系。我们还发现，眼部超声是一种有用的非侵入性的替代方法来确定视乳头水肿的儿童IIH，特别是在紧急情况下。
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.