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Updated: Jan 24, 2026

Intracranial Pressure Monitoring In Nontraumatic Intraventricular Hemorrhage Rodent Model
Published on: February 8, 2022
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.
Abstract:
Intracranial hypertension (ICH) in children refers to increased pressure within the skull. The skull normally contains the brain, blood vessels, meninges, and cerebrospinal fluid (CSF). Abnormalities in any of these intracranial structures may cause ICH. The differential diagnosis for pediatric ICH includes brain tumors; intracranial hemorrhages; intracranial infections; craniosynostosis; disorders of CSF production, clearance, or abnormal CSF contents; and pseudotumor cerebri syndrome (PTCS), which may be primary (also known as idiopathic intracranial hypertension [IIH]) or secondary. Children with suspected ICH should undergo a thorough history and examination, focused on determining whether the child has papilledema and/or abducens nerve palsy. The differential diagnosis of papilledema includes other causes of optic disc edema, such as optic neuritis, as well as pseudopapilledema. The differential diagnosis of abducens nerve palsy includes Duane syndrome and other causes of childhood esotropia. In children with suspected papilledema, ancillary ophthalmic testing including visual fields, optical coherence tomography (OCT), fundus photography, autofluorescence, fluorescein angiography, and ultrasonography may be indicated. The systemic workup for children with suspected ICH includes neuroimaging and lumbar puncture in certain cases. Management of children with ICH is focused on treating any underlying cause and lowering intracranial pressure with medications or surgery.
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