The role of ICP monitoring in paediatric IIH

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Harishchandra Lalgudi Srinivasan1, Carla Richetta2, Nir Manoim3

  • 1Department of Paediatric Neurosurgery, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, 6423609, Tel Aviv, Israel. theneurosurgeon9999@gmail.com.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|April 24, 2020
PubMed

Insights

Idiopathic intracranial hypertension (IIH) diagnosis in children can be unreliable with lumbar puncture opening pressure. Intracranial pressure monitoring is recommended when IIH diagnosis is questionable, preventing unnecessary interventions.

Area of Science:

  • Pediatric Neurology
  • Neurosurgery

Background:

  • Diagnosis of idiopathic intracranial hypertension (IIH) in children often relies on adult guidelines and lumbar puncture opening pressure (LP-OP).
  • LP-OP can be unreliable due to various factors, making it a questionable sole diagnostic criterion.

Purpose of the Study:

  • To analyze the reliability of LP-OP in diagnosing IIH in children.
  • To evaluate the importance of intracranial pressure monitoring (ICPM) when IIH diagnosis is uncertain.

Main Methods:

  • Retrospective review of children diagnosed with IIH over 10 years.
  • Comparison of LP-OP (last and mean) with ICPM in selected children.
  • Analysis of long-term outcomes following diagnostic decisions.

Main Results:

  • Lack of correlation between LP-OP and ICPM in 9 out of 11 children.
  • ICPM refuted IIH diagnosis in 80% of cases, avoiding unnecessary treatments.
  • 90% of children showed no symptom progression on long-term follow-up after ICPM-guided decisions.

Conclusions:

  • Lumbar puncture opening pressure can be unreliable for diagnosing IIH in children.
  • Formal intracranial pressure monitoring is advised in cases of diagnostic doubt for IIH.
Abstract

Keywords:
ICP monitoringIIHLumbar punctureOpening pressurePTC

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