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[Benign intracranial hypertension: experience over 18 years]
L Monge Galindo1, R Pérez Delgado, J López-Pisón
1Unidad de Neuropediatría, Hospital Universitario Miguel Servet, Zaragoza, España.
Anales De Pediatria (Barcelona, Spain : 2003)
|September 29, 2009
Summary
Benign intracranial hypertension (BIH) in children typically resolves favorably, though visual complications can occur. Prompt diagnosis and management are crucial for a positive outcome in pediatric cases.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Neuroimaging
Context:
- Transient intracranial hypertension presents with bulging fontanelle in infants and papilledema in children.
- This study reviews 31 cases of benign intracranial hypertension (BIH) in a pediatric neuropaediatric database over 18 years, excluding other causes.
- BIH diagnosis is typically made by exclusion of other intracranial pathologies.
Purpose:
- To present the experience and outcomes of benign intracranial hypertension (BIH) in pediatric patients.
- To analyze the clinical presentation, diagnostic methods, and treatment outcomes in infants and children with BIH.
- To highlight the importance of ophthalmological control and appropriate management strategies for BIH.
Summary:
- The study identified 31 BIH cases: 16 infants (2.3-8.9 months) with bulging fontanelle and 15 children (4.4-13.7 years) with papilledema.
- Infants often had recent corticosteroid use, while older children had associations with vitamin A excess or mastoiditis.
- Infants recovered quickly; children's recovery varied (1 week-5 months), with some requiring treatment. Imaging and lumbar puncture were key diagnostic tools.
Impact:
- BIH generally has a favorable prognosis in children, but visual impairment, including blindness, is a risk.
- Ophthalmological monitoring is essential for all pediatric BIH cases.
- Advanced imaging (MRI) and lumbar puncture are vital for non-progressing cases, with specific treatments available for refractory cases.
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