Barbagallo M, Vitaliti G, Greco F, Pavone P, Matin N, Panta G, Lubrano R, Falsaperla R
General Paediatrics O.U., Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Catania, Italy.
General Paediatrics O.U., Policlinico-Vittorio Emanuele University Hospital, University of Catania, Italy.
J Biol Regul Homeost Agents. 2017 Jan-Mar;31(1):195-200.
Idiopathic intracranial hypertension (IIH) is a disorder of unknown origin, which is characterized by elevated intracranial pressure (ICP) without underlying etiological evidence of neurological disease. The purpose of the current study was to evaluate epidemiological features, clinical presentation, diagnostic findings and treatment of sixteen children (7 males and 9 females) with IIH. Medical records of the patients were obtained from the University Paediatric Hospital of Catania, Italy. Clinical features, investigations and treatment approaches were retrieved. The mean age of the sixteen children at onset of symptoms was 9 years (range: 4 to 16 years). Most of the patients were classified as pre-pubertal. Mean BMI was 28.9 kg/m2. In 93.75% of patients headache was the presenting clinical symptom; and in the same percentage papilledema was detected as the accompanied sign during diagnostic flow-chart. The mean lumbar puncture opening pressure (LPOP) was 350 mm H2O. Fifty percent of the cases had normal brain imaging, while 12.5% showed enlarged optic nerve diameter and one patient had an intraocular protrusion of the optic nerve on MRI. Two patients (12.5%) had venous sinus stenosis, and one case showed an abnormal spinal MRI. With regard to therapeutic approaches, 93.75% of the cases were successfully treated with Acetazolamide. None of the patients required surgical procedures, and all neuroimaging findings disappeared after receiving treatment. In the present study we investigated the association of IIH with venous sinus stenosis. We also found ocular ultrasound to be a useful non-invasive alternative method for determining papilledema in paediatric IIH, specifically in an emergency.
特发性颅内高压（IIH）是一种病因不明的疾病，其特征是颅内压（ICP）升高，且无潜在神经系统疾病的病因学证据。本研究的目的是评估16例IIH患儿（7例男性，9例女性）的流行病学特征、临床表现、诊断结果及治疗情况。患者的病历来自意大利卡塔尼亚大学儿科医院。检索了临床特征、检查及治疗方法。16例患儿出现症状时的平均年龄为9岁（范围：4至16岁）。大多数患者被归类为青春期前。平均体重指数为28.9kg/m²。93.75%的患者以头痛作为首发临床症状；在诊断流程中，相同比例的患者被检测出伴有视乳头水肿体征。平均腰穿初压（LPOP）为350mm H₂O。50%的病例脑影像学检查正常，而12.5%的病例显示视神经直径增大，1例患者在MRI上有视神经眶内突出。2例患者（12.5%）有静脉窦狭窄，1例病例脊柱MRI检查异常。关于治疗方法，93.75%的病例使用乙酰唑胺治疗成功。所有患者均无需手术治疗，治疗后所有神经影像学检查结果均消失。在本研究中，我们调查了IIH与静脉窦狭窄的相关性。我们还发现眼部超声是一种有用的非侵入性替代方法，可用于确定小儿IIH中的视乳头水肿，尤其是在紧急情况下。
