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Paediatric idiopathic intracranial hypertension

José Nuno Galveia1, Ana Paula Mendonça, João Marques Costa

  • 1Department of Ophthalmology, Hospital Egas Moniz, Lisbon, Portugal. jgalveia@gmail.com

BMJ Case Reports
|January 29, 2013
PubMed

Insights

Idiopathic intracranial hypertension (IIH) in children presents unique challenges. Prompt diagnosis and treatment, including shunting, can lead to complete symptom resolution and vision recovery in pediatric patients.

Area of Science:

  • Pediatric Neurology
  • Ophthalmology
  • Neurosurgery

Background:

  • Idiopathic intracranial hypertension (IIH) is a neurological condition affecting intracranial pressure.
  • Pediatric IIH can manifest differently than in adults, requiring specific diagnostic considerations.

Observation:

  • An 11-year-old boy presented with severe headaches and significant bilateral vision loss (20/200).
  • Fundus examination revealed marked bilateral optic disc and macular edema.
  • Neuroimaging ruled out structural lesions, and lumbar puncture confirmed elevated opening pressure (540 mm Hg).

Findings:

  • The patient was diagnosed with pediatric idiopathic intracranial hypertension.
  • Medical management was initiated, followed by a ventriculoperitoneal shunting procedure.
  • Post-surgery, the patient experienced complete resolution of headaches and vision returned to normal (20/20 bilaterally).

Implications:

  • This case highlights the importance of early recognition and intervention for IIH in children.
  • Ventriculoperitoneal shunting can be an effective treatment for severe pediatric IIH cases unresponsive to medical management.
  • Timely treatment can prevent long-term visual impairment in affected children.

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