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Pediatric intracranial hypertension. Experience from 2 Tertiary Centers
Fahad A Bashiri1, Hissah K Al Abdulsalam, Saeed M Hassan
1Division of Pediatric Neurology, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Insights
Intracranial hypertension (IH) is uncommon in children, often affecting overweight females over 12 years old. Younger children typically develop secondary IH, requiring further research for management.
Area of Science:
- Pediatric Neurology
- Neuro-Ophthalmology
Background:
- Intracranial hypertension (IH) is a condition characterized by elevated pressure within the skull.
- While commonly associated with adults, understanding its presentation in pediatric populations is crucial.
Purpose of the Study:
- To review the experience of two tertiary centers in Saudi Arabia managing pediatric intracranial hypertension.
- To characterize the clinical presentation, associated conditions, and treatment outcomes of pediatric IH.
Main Methods:
- Retrospective review and analysis of pediatric patients diagnosed with IH between June 2002 and May 2017.
- Data collected included patient demographics, presenting features, associated conditions, treatments, and follow-up duration.
Main Results:
- 53 pediatric patients (30 females, 23 males) with a mean age of 7 years were identified.
- Overweight and obese patients constituted 27%, predominantly those older than 12 years.
- Papilledema and headache were the most common symptoms; Vitamin D deficiency was the most frequent associated condition.
- Acetazolamide was the primary treatment (98.11%), with surgery in only 5.7% of cases.
Conclusions:
- Pediatric intracranial hypertension is rare and shares similarities with adult presentation, particularly in overweight females over 12 years.
- Children younger than 12 years are more likely to develop secondary forms of IH.
- Further research is needed to better define clinical characteristics and optimal management strategies for pediatric IH.
Objective:
To review the experience of 2 tertiary centers in Saudi Arabia with intracranial hypertension (IH) in the pediatric population.
Methods:
We retrospectively reviewed and analyzed pediatric patients diagnosed with IH from June 2002 to May 2017 in 2 institutes.
Results:
We identified 53 patients (30 females and 23 males) with a mean age of 7 years at the time of presentation. Among them, 41 patients were younger than 12 years, and 12 were older. Obese and overweight patients constituted 27.00% (n = 14) of all cases, 8 (66.7%) of whom were older than 12 years. The most common presenting feature was papilledema followed by headache. Vitamin D deficiency, which constituted the most common associated condition, was identified in 12 (22.6%) patients. Acetazolamide was the treatment option in 98.11% of patients, and only 5.7% underwent surgical interventions. The length of follow-up ranged from 6 months to 8 years.
Conclusion:
Intracranial hypertension is rare in children and commonly seen in overweight females older than 12 years similar to adults. Patients younger than 12 years tend to develop secondary IH. More studies are needed to characterize the clinical presentation and guide the management plan.
