Under Pressure: Increased Intracranial Pressure in Infants and Children. Presented at the 2024 AOC/AACO/AAO Sunday

Tiffany Yuen1, Aarti Vyas1, Sameea Tahir1

  • 1Division of Ophthalmology, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA.

Insights

Intracranial hypertension (ICH) in children involves increased skull pressure, requiring prompt diagnosis. Management focuses on identifying the cause and reducing pressure through medication or surgery.

Area of Science:

  • Pediatric Neurology
  • Ophthalmology

Background:

  • Intracranial hypertension (ICH) in children is elevated pressure within the skull.
  • Causes include tumors, hemorrhages, infections, CSF disorders, and pseudotumor cerebri syndrome (PTCS).

Purpose of the Study:

  • To outline the differential diagnosis and diagnostic approach for pediatric ICH.
  • To highlight key clinical findings and investigations for suspected ICH.

Main Methods:

  • Thorough history and physical examination, focusing on papilledema and abducens nerve palsy.
  • Ancillary ophthalmic testing (visual fields, OCT, fundus photography, angiography, ultrasonography) for suspected papilledema.
  • Neuroimaging and lumbar puncture for systemic workup.

Main Results:

  • Papilledema and abducens nerve palsy are key indicators of ICH.
  • Differential diagnoses for papilledema and abducens nerve palsy must be considered.
  • Diagnostic workup guides identification of underlying causes.

Conclusions:

  • Prompt diagnosis of pediatric ICH is crucial.
  • Management involves addressing the underlying etiology and reducing intracranial pressure.
  • Multidisciplinary approach including neurology and ophthalmology is essential.

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