Kahle Kristopher T, Walcott Brian P, Staley Kevin J
Department of Neurosurgery, Harvard Medical School and Massachusetts General Hospital, Boston, MA 02114, USA.
J Child Neurol. 2011 Feb;26(2):205-8. doi: 10.1177/0883073810391264.
Medical treatment of idiopathic intracranial hypertension is often ineffective. Cerebrospinal fluid diversion or optic nerve sheath fenestration is employed when medical therapy fails. Here, we describe a case of a 13-year-old girl with idiopathic intracranial hypertension refractory to long-term trials of acetazolamide and furosemide at maximally tolerated doses. After declining surgical intervention despite progression of her visual symptoms, a trial of bumetanide (0.25 mg daily) monotherapy was successful in resolution of the patient's symptoms. These results suggest bumetanide could be effective in the treatment of idiopathic intracranial hypertension, perhaps by restoring the balance between cerebrospinal fluid formation and absorption and/or by altering the volume or ionic composition of the brain's extracellular fluid compartment.
特发性颅内高压的药物治疗往往无效。当药物治疗失败时，会采用脑脊液分流术或视神经鞘开窗术。在此，我们描述一例13岁女孩，她对乙酰唑胺和呋塞米进行最大耐受剂量的长期试验均难治性特发性颅内高压。尽管视觉症状进展，但她拒绝手术干预，布美他尼（每日0.25毫克）单药试验成功缓解了患者症状。这些结果表明布美他尼可能对治疗特发性颅内高压有效，或许是通过恢复脑脊液生成与吸收之间的平衡和/或改变脑细胞外液腔的容积或离子组成来实现的。
