Management of pediatric patients with pseudotumor cerebri

Chern, Joshua J.; Tubbs, R. Shane; Gordon, Amber S.; Donnithorne, Katherine J; Oakes, W. Jerry

doi:10.1007/s00381-011-1657-9

Cited by 8 publications

(2 citation statements)

References 21 publications

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“…There is no consensus on a specifi c level of ICP to defi ne the condition. However, most centers would agree that the lumbar pressure should be more than 20 cm H 2 O [ 9 ].…”

Section: Idiopathic Intracranial Hypertension (Iih)mentioning

confidence: 96%

Management of Increased Intracranial Pressure

Gustavsson

2013

Acute Pediatric Neurology

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This chapter discusses the intracranial pressure (ICP) in the growing child and young adult. The purpose is to give the reader a condensed view of possible causes, symptoms, and the basal initial management in general and at different ages in the child with a pathological high intracranial pressure. Keywords IntroductionThe intracranial pressure (ICP) is dependent on three compartments inside the fi xed volume of the cranium: volumes of the brain, blood, and cerebrospinal fl uid (CSF), respectively. Brain tissue occupies about 80 % of the total intracranial volume. The remaining 20 % are evenly shared by blood (in arteries and veins) and CSF (in the ventricles, the basal cisterns, and the subarachnoid space). Since these volumes are not compressible, ICP is normally measured by assuming that it is evenly distributed among all intracranial compartments, including the intradural space of the spinal canal. This also assumes that the CSF circulation is constant without any obstruction.The normal intracranial pressure increases with age (Table 12.1 ), partly because the cranial bones that cover the brain will be more rigid as the fontanels and the sutures close with age. As the child gets older, the calvarial bone and meninges increase in size as the brain matures; also the volumes of blood and cerebrospinal fl uid (CSF) increase as the child grows. After the fontanels are closed, the intracranial volume becomes constant. This means that if one intracranial component increases in volume, it can be compensated by a decreased volume in one or both of

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“…There is no consensus on a specifi c level of ICP to defi ne the condition. However, most centers would agree that the lumbar pressure should be more than 20 cm H 2 O [ 9 ].…”

Section: Idiopathic Intracranial Hypertension (Iih)mentioning

confidence: 96%

Management of Increased Intracranial Pressure

Gustavsson

2013

Acute Pediatric Neurology

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“…Patients presenting with significant visual loss may require a surgical intervention, typically a neurosurgical shunting procedure, to quickly and effectively lower the intracranial pressure. 39 Although these procedures have considerable morbidity and mortality, they can be justified in cases of fulminant or progressive vision loss that can become irreversible without emergent intervention. The utility of neurosurgical shunting procedures in cases of severe visual loss secondary to IIH is the focus of the SIGHT trial (NCT03501966), although this trial will not include pediatric patients like the IIHTT.…”

Section: Treatmentmentioning

confidence: 99%

Pediatric Idiopathic Intracranial Hypertension

Gaier

Heidary

2019

Semin Neurol

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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.

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