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Survey of Ophthalmology 1979The authors evaluate the case of a 20-year-old, four-month-pregnant woman who presented with papilledema and visual field loss, and developed headache, intermittent...
The authors evaluate the case of a 20-year-old, four-month-pregnant woman who presented with papilledema and visual field loss, and developed headache, intermittent diplopia and impairment of color vision over the next month. The procedures and considerations leading to the diagnosis of pseudotumor cerebri are discussed, as are the various modes of therapy and their indications.
Topics: Adult; Female; Humans; Methods; Papilledema; Pregnancy; Pseudotumor Cerebri; Scotoma
PubMed: 462365
DOI: 10.1016/0039-6257(79)90161-9 -
Seminars in Neurology Dec 2019The presentation of idiopathic intracranial hypertension (IIH) in pediatric populations has several important distinctions from that in adults, especially among... (Review)
Review
The presentation of idiopathic intracranial hypertension (IIH) in pediatric populations has several important distinctions from that in adults, especially among prepubertal patients, in which there is no apparent association with gender or obesity. Pediatric patients are more likely to be asymptomatic or present with atypical symptoms than their adult counterparts, posing a diagnostic challenge in some cases. It is important to be aware of the ways in which diagnostic criteria for IIH are modified from that of adults. Ideal treatment practices and the natural history of pediatric IIH remain unclear. Acetazolamide is the mainstay of medical treatment, but some patients with significant visual loss may require surgical intervention. Multicenter studies to accrue a large number of cases and future prospective studies will help to better define pediatric IIH and to formulate consensus guidelines for treatment and management of these patients.
Topics: Child; Humans; Papilledema; Pseudotumor Cerebri; Vision Disorders
PubMed: 31847041
DOI: 10.1055/s-0039-1698743 -
Journal of Neuro-ophthalmology : the... Mar 2022
Topics: Humans; Pseudotumor Cerebri; Tetracyclines
PubMed: 34270516
DOI: 10.1097/WNO.0000000000001281 -
Hormone Research in Paediatrics 2010Idiopathic intracranial hypertension (IIH), or pseudotumor cerebri, is a condition of elevated intracranial pressure in the absence of clinical, laboratory or... (Review)
Review
Idiopathic intracranial hypertension (IIH), or pseudotumor cerebri, is a condition of elevated intracranial pressure in the absence of clinical, laboratory or radiological evidence of an intracranial space occupying lesion that can occur in the pediatric population. While IIH is more commonly recognized as a disorder of adults, it affects children of all ages and can have distinctive characteristics when presenting in the prepubertal age group. This review discusses the demographics, clinical presentation, diagnosis, neuroimaging, and management of pediatric IIH. Common etiologies of IIH in children, with particular focus on endocrine abnormalities, are highlighted.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Intracranial Hypertension; Male; Pseudotumor Cerebri
PubMed: 20962512
DOI: 10.1159/000321180 -
Current Opinion in Ophthalmology Nov 2008To review the current standard of care in the diagnosis and treatment of idiopathic intracranial hypertension (IIH). We also discuss recent advances in the understanding... (Review)
Review
PURPOSE OF REVIEW
To review the current standard of care in the diagnosis and treatment of idiopathic intracranial hypertension (IIH). We also discuss recent advances in the understanding of the pathogenesis of IIH with emerging trends in management of this syndrome.
RECENT FINDINGS
There has been increasing literature suggesting a role of vitamin A, adipokines, sleep disorders, and venous sinus stenosis in the pathogenesis of IIH. Newer medical treatment options like topiramate and surgical treatment options like stereotactic ventriculoperitoneal shunting have been found to be attractive alternatives. There has also been an emerging interest in cerebral venous sinus stenting, though its role and utility remain debatable.
SUMMARY
This article seeks to present a systematic approach to the management of IIH. Many newer treatment modalities are being explored for IIH refractory to standard medical therapy, but their efficacy and safety must be demonstrated in large studies before they can be adopted as part of standard treatment.
Topics: Cerebrospinal Fluid; Fructose; Humans; Intracranial Hypertension; Papilledema; Pseudotumor Cerebri; Risk Factors; Topiramate; Ventriculoperitoneal Shunt
PubMed: 18854688
DOI: 10.1097/ICU.0b013e3283112d3e -
Archivos Argentinos de Pediatria Apr 2014
Topics: Child; Female; Humans; Pseudotumor Cerebri
PubMed: 24584797
DOI: 10.5546/aap.2014.198 -
Ophthalmology Clinics of North America Mar 2001There is perhaps no neuro-ophthalmic sign that is as ominous as papilledema. True papilledema from increased intracranial pressure may be a harbinger of serious... (Review)
Review
There is perhaps no neuro-ophthalmic sign that is as ominous as papilledema. True papilledema from increased intracranial pressure may be a harbinger of serious neurological disease. There, however, are other conditions that may mimic papilledema, contributing to the diagnostic dilemma. This article concerns the detection and differential diagnosis of papilledema, focusing on increased intracranial pressure without a mass lesion (pseudotumor cerebri).
Topics: Diagnosis, Differential; Diagnostic Techniques, Ophthalmological; Humans; Papilledema; Pseudotumor Cerebri
PubMed: 11370563
DOI: No ID Found -
Current Opinion in Ophthalmology Dec 1998The development of papilledema requires high cerebrospinal fluid (CSF) pressure in the distal optic nerve sheath, elevation of the pressure in the central retinal vein,... (Review)
Review
The development of papilledema requires high cerebrospinal fluid (CSF) pressure in the distal optic nerve sheath, elevation of the pressure in the central retinal vein, and impaired perfusion of the neurons as they traverse the lamina cribrosa. Pseudotumor cerebri (PTC) is a syndrome defined by four criteria: 1) Increased intracranial pressure, 2) normal or small ventricles on neuroimaging, 3) no evidence of an intracranial mass, and 4) normal CSF composition. Elevated intracranial venous pressure is thought by some authors to be the "universal mechanism" of PTC of varying etiologies. The reason obesity predisposes to idiopathic PTC is unclear, but one mechanism proposed is that central obesity raises intra-abdominal pressure, which increases pleural pressure and cardiac filling pressures, which impede venous return from the brain, leading to increased intracranial venous pressure and increased intracranial pressure. Both optic nerve sheath fenestration (ONSF) and lumboperitoneal shunting (LPS) may improve vision and prevent deterioration of vision in patients with PTC. Both procedures have their advantages and disadvantages, but until a prospective, randomized study comparing ONSF with LPS for PTC is performed, the question of which surgical procedure is best for the treatment of PTC remains unanswered.
Topics: Adult; Female; Humans; Intracranial Hypertension; Intracranial Pressure; Magnetic Resonance Imaging; Male; Papilledema; Pseudotumor Cerebri
PubMed: 10387332
DOI: 10.1097/00055735-199812000-00005 -
Clinical Rheumatology Apr 2021
Topics: Humans; Pseudotumor Cerebri
PubMed: 33174108
DOI: 10.1007/s10067-020-05503-8 -
Arquivos de Neuro-psiquiatria Nov 2018To report cases of children and adolescents diagnosed with pseudotumor cerebri associated or not with rheumatic disease.
OBJECTIVE
To report cases of children and adolescents diagnosed with pseudotumor cerebri associated or not with rheumatic disease.
METHODS
This was a retrospective study based on medical reports of 29 patients, up to 18 years of age and diagnosed with pseudotumor cerebri, followed up in the Pediatric Rheumatology and Neurology outpatient clinics of a tertiary hospital, until December 2016.
RESULTS
Among the 29 patients diagnosed with pseudotumor cerebri, 51.7% were girls and the mean age at the disease onset was 12.3 years. In 18 patients (62%) where an etiology was found, four were associated with a rheumatic disease. The most common symptom was headache (69%) and acetazolamide was the most used medication (69%). Two patients developed blindness and 10 are still being followed up.
CONCLUSION
Although rare, pseudotumor cerebri should be considered in children with headaches, especially in patients with rheumatic disease.
Topics: Acetazolamide; Adolescent; Child; Child, Preschool; Female; Headache; Humans; Male; Papilledema; Pseudotumor Cerebri; Retrospective Studies; Rheumatic Diseases; Young Adult
PubMed: 30570018
DOI: 10.1590/0004-282X20180131