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Pediatric Intracranial Hypertension.

Shawn C Aylward1, Rachel E Reem2

  • 1Department of Neurology, Nationwide Children's Hospital, Columbus, Ohio.

Pediatric Neurology
|December 13, 2016
PubMed
Summary

Idiopathic intracranial hypertension (IIH) in children is not rare, with headache being a key symptom. Treatment focuses on weight loss and medication, though some patients develop chronic headaches post-resolution.

Keywords:
headacheintracranial hypertensionpediatricpseudotumor cerebri

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Area of Science:

  • Neurology
  • Pediatrics
  • Ophthalmology

Background:

  • Idiopathic intracranial hypertension (IIH) is increasingly recognized in pediatric populations.
  • Accurate pediatric incidence data in the United States are lacking.
  • Diagnostic criteria have evolved, adapting adult standards for children.

Purpose of the Study:

  • To review the current understanding of pediatric idiopathic intracranial hypertension.
  • To highlight diagnostic challenges and clinical presentations across different age groups.
  • To outline current treatment strategies and potential complications.

Main Methods:

  • Review of existing literature on pediatric idiopathic intracranial hypertension.
  • Analysis of clinical presentations, diagnostic criteria, and treatment outcomes.
  • Discussion of age-specific variations in symptomatology.

Main Results:

  • Clinical presentation of IIH varies significantly with age, often subtle in younger children.
  • Optic disc edema is a common incidental finding in prepubertal children.
  • Headache is the most consistent symptom, accompanied by nausea, vomiting, tinnitus, and diplopia.

Conclusions:

  • Weight loss and acetazolamide are primary treatments for pediatric IIH.
  • Furosemide may enhance acetazolamide's efficacy.
  • Surgical options like optic nerve fenestration and CSF shunting are reserved for refractory cases.
  • Aggressive management is crucial to prevent vision loss and manage pain.
  • A significant proportion of patients experience new or chronic headaches after initial recovery.