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Intracranial hypertension: a current review

Catherine O Jordan1, Shawn C Aylward2

  • 1Department of Ophthalmology.

Current Opinion in Pediatrics
|September 7, 2018
PubMed

Insights

Idiopathic intracranial hypertension (IIH) affects children, with most cases responding to acetazolamide. The Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) provides valuable adult data to aid pediatric management.

Area of Science:

  • Neurology
  • Ophthalmology
  • Pediatrics

Background:

  • Intracranial hypertension (IIH) is a neurological condition characterized by elevated pressure within the skull.
  • While adult data is more abundant, pediatric IIH remains a concern with specific incidence rates and treatment considerations.

Purpose of the Study:

  • To review recent publications on intracranial hypertension, focusing on pediatric cases and leveraging adult trial data.
  • To synthesize current understanding of IIH symptomatology, treatment efficacy, and outcomes in children.

Main Methods:

  • Review of recent literature on intracranial hypertension.
  • Analysis of data from the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) for adult insights.
  • Evaluation of pediatric incidence rates and treatment responses.

Main Results:

  • Pediatric IIH incidence ranges from 0.63-0.71 per 100,000 children.
  • Acetazolamide effective in most pediatric cases, with headache resolution in ~3.8 weeks.
  • Fluorescein angiography highly accurate for papilledema diagnosis; IIHTT showed high agreement in Frisen grade assessment.

Conclusions:

  • Intracranial hypertension is a significant concern in pediatrics, despite lower incidence than adults.
  • The IIHTT offers crucial data to inform and improve the management of pediatric IIH.
  • Acetazolamide is a primary treatment option with a favorable safety profile in pediatric patients.
Abstract

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