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Management of pediatric patients with pseudotumor cerebri
Joshua J Chern1, R Shane Tubbs, Amber S Gordon
1Department of Pediatric Neurosurgery, Children's Hospital, Birmingham, AL, USA. jc691586@gmail.com
Insights
Pediatric pseudotumor cerebri (idiopathic intracranial hypertension) management requires a multidisciplinary approach. Most young patients respond to lumbar punctures and medication, but some may need neurosurgery for optimal outcomes.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Ophthalmology
Background:
- Pseudotumor cerebri, also known as idiopathic intracranial hypertension, presents differently in children compared to adults.
- Management of pediatric pseudotumor cerebri involves a team of ophthalmologists, neurologists, and neurosurgeons.
Purpose of the Study:
- To describe the clinical characteristics and management of pediatric pseudotumor cerebri.
- To evaluate the outcomes of various treatment modalities, including neurosurgical interventions.
Main Methods:
- Retrospective review of 59 pediatric patients diagnosed with pseudotumor cerebri.
- Data collected from ophthalmology, neurology, and neurosurgery departments.
Main Results:
- Average age at diagnosis was 11.4 years, with an average lumbar puncture opening pressure of 37 cm H2O.
- Most patients improved with therapeutic lumbar punctures and medical management.
- Nine patients underwent neurosurgical interventions (intracranial pressure monitoring, shunt insertion); one of three with acute visual decline remained legally blind.
Conclusions:
- Effective care for pediatric pseudotumor cerebri necessitates a multidisciplinary approach.
- Neurosurgical interventions are sometimes required for diagnosis and treatment.
- Timely and accurate communication among specialists is crucial for optimal patient outcomes.
Introduction:
The care of patients with pseudotumor cerebri (idiopathic intracranial hypertension) involves ophthalmologists, neurologists and neurosurgeons. Its clinical characteristics in the pediatric population are distinct from those in adult patients.
Patients And Methods:
Fifty-nine patients diagnosed with pseudotumor cerebri were identified from the neurosurgery and neurology databases at Children's Hospital, Birmingham, AL, USA. Clinical data were collected from the ophthalmology, neurology and neurosurgery departments.
Results:
The average age of patients at diagnosis was 11.4 years (range 3-17). The average opening pressure of lumbar puncture (LP) was 37 cm of water. Most of the patients responded well to therapeutic LPs and medical management. Neurosurgical interventions included intracranial pressure monitoring and shunt insertion in nine patients. In three patients who presented with acute visual decline, two recovered and one remains legally blind.
Conclusions:
The care of patients with pseudotumor cerebri requires a multiple-disciplinary approach. Neurosurgical interventions are sometimes needed for diagnostic and treatment purpose. Prompt and accurate communication among specialists is necessary to ensure timely treatment and optimal outcomes.
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