Jirásková Nad'a, Rozsíval Pavel
Department of Ophthalmology, University Hospital, Hradec Králové, Czech Republic.
Clin Ophthalmol. 2008 Dec;2(4):723-6. doi: 10.2147/opth.s1593.
To evaluate retrospectively the features, treatment, and outcome of idiopathic intracranial hypertension (IIH) in children.
Nine patients, 15 years and younger, diagnosed with IIH. Inclusion criteria were papilledema, normal brain computer tomography or magnetic resonance imaging, cerebrospinal fluid pressure greater than 250 mm H(2)O, normal cerebrospinal fluid content, and a nonfocal neurologic examination except for sixth nerve palsy.
Of the nine patients, eight were girls. Five girls were overweight and one boy was obese. The most common presenting symptom was headache (5 patients). Diplopia or strabismus did not occur in our group. Visual field abnormalities were present in all eyes, and severe visual loss resulting in light perception vision occurred in both eyes of one patient. Eight patients were treated medically with acetazolamide alone, and one girl needed a combination of acetazolamide and corticosteroids. This girl also required optic nerve sheath decompression surgery. Resolution of papilledema and recovery of visual function occurred in all patients.
Idiopathic intracranial hypertension in prepubertal children is rather uncommon. Prompt diagnosis and management are important to prevent permanent visual loss.
回顾性评估儿童特发性颅内高压（IIH）的特征、治疗及预后。
9例15岁及以下诊断为IIH的患者。纳入标准为视乳头水肿、脑计算机断层扫描或磁共振成像正常、脑脊液压力大于250 mm H₂O、脑脊液成分正常，以及除第六脑神经麻痹外无局灶性神经系统检查异常。
9例患者中，8例为女孩。5名女孩超重，1名男孩肥胖。最常见的首发症状是头痛（5例患者）。我们的研究组未出现复视或斜视。所有患者均有视野异常，1例患者双眼出现严重视力丧失，仅存光感。8例患者仅接受乙酰唑胺药物治疗，1名女孩需要联合使用乙酰唑胺和皮质类固醇。该女孩还需要进行视神经鞘减压手术。所有患者视乳头水肿均消退，视功能恢复。
青春期前儿童特发性颅内高压相当罕见。及时诊断和治疗对于预防永久性视力丧失很重要。
