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Pediatría Atención Primaria

Print version ISSN 1139-7632

Abstract

ALVAREZ CASANO, María; CALVO MEDINA, Rocío  and  MARTINEZ ANTON, Jacinto. Idiopathic intracranial hypertension: epidemiology and current literature review. Rev Pediatr Aten Primaria [online]. 2019, vol.21, n.81, pp.15-20.  Epub Oct 14, 2019. ISSN 1139-7632.

Introduction:

the characteristics of idiopathic intracranial hypertension are analyzed; epidemiology, clinic at the beginning, tests performed, treatment and evolution that presented the analyzed cases.

Material and methods:

a retrospective descriptive study was conducted on patients with idiopathic intracra­nial hypertension in the last seven years (2011-2017), in a third level hospital.

Results:

forty patients (55% women) were studied, with a mean age of 9.6 years. As associated factors, 5% had a treatment with growth hormone. It is important to note that only 25% were overweight or obese. The main symptom was oppressive headache, without predominance hours, associating vomiting (27.5%), or visual alterations (22%). Three asymptomatic patients presented a chance finding of bilateral papilledema. The physical examination was anodyne (65%), showing strabismus due to cranial nerve palsy VI (35%). 62,5% presented papilledema, and the campimetry was only performed in 55% of the patients, altered in 50% of them. The time to diagnosis was 44.8 days. We obtained an average opening pressure of 29.7 cm HO (± 8.2). CT was performed (85%), being normal (88.2%). MRI of the skull (7.5%), normal (70%). Angio-NMR (5%), all normal. Analytical was requested, with renal and hepatic function (62.5%, all normal), hormonal (65%), thrombophilic study and autoimmunity (10% and 20% respectively, anodyne). Treatment was started with acetazolamide (95%), requiring the addition of corticotherapy due to lack of response 24%. In 5%, it spontaneously self-limited. As a last step, 7.5% required a lumboperitoneal bypass valve. They evolved favora­bly 95%, relapsing 15%. Redialing the average time to resolution was 3.9 months.

Conclusion:

idiopathic intracranial hypertension is rare, but its diagnosis and early treatment is essential to avoid possible irreversible sequelae. The ophthalmological study, by fundus and especially campimetry, is es­sential for the diagnosis, monitoring and determination of the aggressiveness of the treatment.

Keywords : Papilloedema; Campimetry; Intracranial hypertension.

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