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Pediatría Atención Primaria
versión impresa ISSN 1139-7632
Resumen
ALVAREZ CASANO, María; CALVO MEDINA, Rocío y 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 14-Oct-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.
Palabras clave : Papilloedema; Campimetry; Intracranial hypertension.