Pseudotumour cerebri in children: aetiology, clinical features, and progression

ConclusionsThe incidence of PTC was estimated at approximately 1 case per 100 000 children/years, in line with data reported by previous studies. Overweight was not found to be a risk factor for PTC in this population. M. pneumoniae infection may trigger PTC and cause recurrences at later stages. The absence of symptoms seems to be independent from the degree of intracranial hypertension. Acetazolamide treatment is effective in most cases, and it represents a viable alternative to repeated LP.ResumenIntroducciónEl síndrome de hipertensión intracraneal idiopática o seudotumor cerebri (STC) en niños está en constante revisión, respecto a su definición, etiologías asociadas, diagnóstico y terapéutica más apropiada.Objetivos y métodosSe revisaron los casos de STC 25cmH2O por punción lumbar (PL), con estudio de resonancia magnética cerebral sin lesión ocupante de espacio.ResultadosSe registró a 12 niños con STC, media de edad de 10 años, 90% mujeres. Todos presentaban peso normal. El 82% manifestaba síntomas: cefalea (66%), diplopía (8%) o baja visión (8%). Todos asociaban papiledema (17% unilateral). La PL fue diagnóstica en el 100% y la neuroimagen fue normal en el 91%. Se evidenció un posible desencadenante en 5 casos (2 farmacológico y 3 infeccioso por Mycoplasma pneumoniae [M. pneumoniae]). El 91% r...
Source: Neurologia - Category: Neurology Source Type: research

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ConclusionsThe knowledge base for idiopathic intracranial hypertension has greatly expanded over the past 25 years. This disease is associated with a number of conditions directly relevant to otolaryngologists. A keen understanding of this disorder and its management may optimize outcomes in a growing number of patients. Laryngoscope, 2017
Source: The Laryngoscope - Category: ENT & OMF Authors: Tags: Otology/Neurotology Source Type: research
(A A Case Rep. 2016;6:160–162) In this case report, a 32-year-old primigravida woman with a history of idiopathic intracranial hypertension (IIH) presented to the labor and delivery suite at 40 weeks gestation in active labor and with pseudotumor cerebri syndrome (PTCS). PTCS, which includes IIH, is a rare disorder mainly of obese women of childbearing age, characterized by increased intracranial pressure in the absence of a space-occupying lesion, ventriculomegaly, or abnormal cerebrospinal fluid (CSF) composition. Symptoms include headache, pulsatile tinnitus, back pain, dizziness, photophobia, neck pain, cognitiv...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Case Reports Source Type: research
Conclusions: Diagnostic errors resulted in overdiagnosis of IIH in 39.5% of patients referred for presumed IIH, and prompted unnecessary tests, invasive procedures, and missed diagnoses. The most common errors were inaccurate ophthalmoscopic examination in headache patients and thinking biases, reinforcing the need for rapid access to specialists with experience in diagnosing optic nerve disorders. Indeed, the high prevalence of primary benign headaches and obesity in young women often leads to costly and invasive evaluations for presumed IIH. (C) 2016 by North American Neuro-Ophthalmology Society
Source: Journal of Neuro-Ophthalmology - Category: Opthalmology Tags: Literature Commentary: PDF Only Source Type: research
Conclusions: IIH may manifest as intractable N/V in the absence of headache in adults. N/V can be an isolated clinical manifestation of IIH and should be excluded when symptoms do not improve with standard therapy. A high degree of suspicion is needed to diagnose IIH without headache.Disclosure: Dr. Bouges has nothing to disclose. Dr. AlSaid has nothing to disclose. Dr. Chaudhry has nothing to disclose. Dr. Hassan has nothing to disclose. Dr. Cupler has received personal compensation for activities with Novartis and Genzyme.
Source: Neurology - Category: Neurology Authors: Tags: General Neurology: Vascular Disease and Imaging Source Type: research
CONCLUSION: Glyburide has been shown to decrease intracranial pressure in acute ischemic strokes both in animal studies and early human clinical trials by blocking SURI-1-sodium channel receptors. This is the first time the effectiveness of Glyburide has been documented in patients with IIH. Further studies are needed to evaluate the effectiveness of Glyburide in decreasing cerebral spine fluid pressure in intracranial idiopathic hypertension.Disclosure: Dr. Ahad has nothing to disclose. Dr. Ahmed has nothing to disclose. Dr. Ahmed has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Headache: Therapeutics Source Type: research
The objective of this study was to describe national trends in patients hospitalized with migraine in the United States over an 11-year period. Methods Data from the National Inpatient Sample (NIS) for the period 2002-2012 was retrospectively reviewed. All hospitalizations with a primary diagnosis of migraine from the ICD-9-CM were analyzed. Results In 2012, there were an estimated 54,510 hospitalizations of migraine compared with 43,791 such hospitalizations in 2002. The highest prevalence of migraine was among adults 35-44 years. The prevalence was greater in whites (72.1[percnt]) and females (79.5[percnt]). Of all 101,1...
Source: Neurology - Category: Neurology Authors: Tags: Headache: Health Services/Outcomes Research, Genetics, and Therapeutics Source Type: research
Conclusions: Diagnostic errors resulted in overdiagnosis of IIH in 39.5% of patients referred for presumed IIH, and prompted unnecessary tests, invasive procedures, and missed diagnoses. The most common errors were inaccurate ophthalmoscopic examination in headache patients and thinking biases, reinforcing the need for rapid access to specialists with experience in diagnosing optic nerve disorders. Indeed, the high prevalence of primary benign headaches and obesity in young women often leads to costly and invasive evaluations for presumed IIH.
Source: Neurology - Category: Neurology Authors: Tags: Idiopathic intracranial hypertension, Clinical neurology history, Clinical neurology examination, Optic nerve ARTICLE Source Type: research
CONCLUSIONS: Although the two included RCTs showed modest benefits for acetazolamide for some outcomes, there is insufficient evidence to recommend or reject the efficacy of this intervention, or any other treatments currently available, for treating people with IIH. Further high-quality RCTs are required in order to adequately assess the effect of acetazolamide therapy in people with IIH. PMID: 26250102 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
Authors: De Simone R, Ranieri A, Montella S, Bilo L, Cautiero F Abstract In recent years the efficacy of endovascular venous stenting in idiopathic IIH treatment has been consistently reported, strongly suggesting that sinus stenosis should be viewed as a causative factor rather than a secondary phenomenon. We propose that in subjects carrying one or more collapsible segments of large cerebral venous collectors and exposed to a number of different promoting factors, sinus venous compression and cerebrospinal fluid (CSF) hypertension may influence each other in a circular way, leading to a new relatively stable veno...
Source: Panminerva Medica - Category: Journals (General) Tags: Panminerva Med Source Type: research
CONCLUSIONS: Diagnostic errors resulted in the incorrect diagnosis of IIH in 48.7[percnt] of patients and prompted unnecessary tests in 44[percnt], invasive procedures in 41[percnt] and missed diagnoses in 10[percnt]. The most common error was inaccurate funduscopic examination in headache patients, reinforcing the need for rapid and easy access to neuro-ophthalmologists. Study Support: RPB, P30-EY006360, K23-EY019341.Disclosure: Dr. Fisayo has nothing to disclose. Dr. Biousse has received personal compensation for activities with GenSight. Dr. Biousse has received personal compensation in an editorial capacity for Up To D...
Source: Neurology - Category: Neurology Authors: Tags: Headache II Source Type: research
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