Krahulik David, Hrabalek Lumir, Blazek Filip, Halaj Matej, Slachta Marek, Klaskova Eva, Maresova Klara
Department of Neurosurgery, University Hospital Olomouc, 779 00 Olomouc, Czech Republic.
Department of Pediatrics, University Hospital Olomouc, 779 00 Olomouc, Czech Republic.
Children (Basel). 2023 Apr 14;10(4):723. doi: 10.3390/children10040723.
Our study evaluates the sensitivity of papilledema as a sign of high intracranial pressure in children. Patients younger than 18 years old, diagnosed with increased ICP, and who had received dilated fundus examination between 2019 and 2021 were retrospectively reviewed. Factors including the patient's age, sex, aetiology, duration of signs or symptoms, intracranial pressure (ICP), and presence of papilledema were evaluated. We included 39 patients in this study, whose mean age was 6.7 years. The 31 patients without papilledema had a mean age of 5.7 years, and 8 patients (20%) with papilledema had a mean age of 10.4 ( < 0.037). The mean duration of signs or symptoms was nine weeks in patients without papilledema and seven weeks in those with papilledema ( = 0.410). The leading causes of increased ICP with papilledema were supratentorial tumor (12.5%), infratentorial tumor (33.3%), and hydrocephalus (20%) ( = 0.479). Papilledema was statistically significantly more common in older patients. We found no statistical significance between sex, diagnosis, and symptoms. The relatively low incidence of papilledema (20%) in our study shows that papilledema's absence does not ensure the absence of increased ICP, especially in younger patients.
我们的研究评估了视乳头水肿作为儿童颅内高压体征的敏感性。对2019年至2021年间年龄小于18岁、被诊断为颅内压升高且接受过散瞳眼底检查的患者进行了回顾性研究。评估了包括患者年龄、性别、病因、体征或症状持续时间、颅内压（ICP）以及视乳头水肿情况等因素。本研究纳入了39例患者，平均年龄为6.7岁。31例无视乳头水肿的患者平均年龄为5.7岁，8例（20%）有视乳头水肿的患者平均年龄为10.4岁（<0.037）。无视乳头水肿患者的体征或症状平均持续时间为9周，有视乳头水肿患者为7周（=0.410）。伴有视乳头水肿的颅内压升高的主要原因是幕上肿瘤（12.5%）、幕下肿瘤（33.3%）和脑积水（20%）（=0.479）。视乳头水肿在年龄较大的患者中在统计学上更为常见。我们发现性别、诊断和症状之间无统计学意义。我们研究中视乳头水肿的发生率相对较低（20%），这表明视乳头水肿的不存在并不能确保颅内压没有升高，尤其是在较年轻的患者中。
