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Cranial morcellation decompression for refractory idiopathic intracranial hypertension in children

Matheus Fernando Manzolli Ballestero1, Thiago Lyrio Teixeira2, Lucas Pires Augusto2

  • 1Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, Brazil. ballestero@gmail.com.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|March 5, 2018
PubMed

Insights

Cranial morcellation decompression (CMD) offers a safe surgical option for children with refractory idiopathic intracranial hypertension (IIH). This technique effectively stabilizes intracranial pressure, preventing potential vision loss in these rare cases.

Area of Science:

  • Pediatric Neurosurgery
  • Neurology
  • Ophthalmology

Background:

  • Primary idiopathic intracranial hypertension (PIIH) is a rare pediatric condition with unknown causes.
  • Characterized by elevated intracranial pressure (ICP) without a detectable brain lesion.
  • Refractory PIIH can lead to severe visual impairment.

Purpose of the Study:

  • To evaluate cranial morcellation decompression (CMD) as a novel surgical approach.
  • To assess CMD's efficacy in stabilizing intracranial pressure in pediatric PIIH.
  • To provide a new surgical alternative for refractory PIIH cases.

Main Methods:

  • Literature review of pediatric PIIH surgical treatments.
  • Detailed case report of a patient treated with CMD.
  • Analysis of CMD technique for intracranial pressure management.

Main Results:

  • Only 7 pediatric cases of PIIH treated with surgical skull expansion found in literature.
  • Successful application of CMD in one pediatric case.
  • Demonstrated stabilization of intracranial pressure post-CMD.

Conclusions:

  • Cranial morcellation decompression (CMD) is a safe and effective surgical option.
  • CMD is suitable for selected pediatric patients with refractory PIIH.
  • This technique offers a viable solution for managing elevated ICP in PIIH.
Abstract

Keywords:
CraniotomyIdiopathic intracranial hypertensionPapilledemaPseudotumor cerebriTechnique

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