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Related Experiment Videos

Pseudotumor cerebri in children.

P H Phillips1, M X Repka, S R Lambert

  • 1Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-9009, USA.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|October 26, 1999
PubMed
Summary

Pseudotumor cerebri in children can lead to permanent vision loss, with optic nerve atrophy affecting one-third of patients. Early detection and monitoring are crucial for managing this condition.

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Area of Science:

  • Pediatric Neurology
  • Ophthalmology
  • Neuroimaging

Background:

  • Pseudotumor cerebri (PTC), or idiopathic intracranial hypertension, requires updated demographic and outcome data in the era of advanced neuroimaging.
  • Understanding PTC in pediatric populations is essential for effective diagnosis and management.

Purpose of the Study:

  • To describe the demographic characteristics and outcomes of children diagnosed with pseudotumor cerebri.
  • To analyze associated etiologic factors and long-term visual prognosis in pediatric PTC cases.

Main Methods:

  • Retrospective review of medical records for children under 18 diagnosed with PTC between 1977 and 1997.
  • Defined PTC by increased intracranial pressure, normal/small ventricles, and normal cerebrospinal fluid composition.

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  • Excluded cases later diagnosed with central nervous system malignancy.

    • Main Results:

    • 35 pediatric patients with PTC were analyzed (10 idiopathic, 25 associated with other disorders).
    • Mean age was 10.6 years; 57% were female, 37% obese.
    • Visual deficits (visual acuity <20/40, visual field deficits, cranial nerve deficits) were present at diagnosis, with most cranial nerve deficits resolving.
    • Optic nerve atrophy occurred in 33% of patients; residual visual field deficits were noted in some at follow-up.

    Conclusions:

    • Associated etiologic factors are common in pediatric PTC; gender predominance was not observed.
    • Permanent visual loss can occur, highlighting the importance of sensitive visual assessment methods.
    • Quantitative perimetry and optic nerve examination are more effective than visual acuity for detecting visual system damage.
    • Rare cases of PTC may mask intracranial neoplasms, necessitating extended follow-up.