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[特发性颅内高压。回顾我们过去八年(2016 - 2023年)的经验]

[Idiopathic intracranial hypertension. Review of our experience in the last eight years (2016-2023)].

作者信息

Torres-Díaz M, Cáceres-Marzal C, Sardina-González M D, Real-Terrón R

机构信息

Hospital Materno Infantil, Badajoz, España.

出版信息

Rev Neurol. 2024 Aug 1;79(3):89-93. doi: 10.33588/rn.7903.2024112.

Abstract

INTRODUCTION

Idiopathic intracranial hypertension (IIH) or benign intracranial hypertension is a rare disease in childhood. The clinical presentation in pediatric patients can be very variable, being more unespecific in younger patients.

PATIENTS AND METHODS

A retrospective descriptive study was carried out on patients diagnosed of IIH in the last eight years (2016-2023) in the neuropediatrics unit of a tertiary hospital. In the present study, the clinical-epidemiological characteristics and the diagnostic-therapeutic procedure carried out in each case were analyzed.

RESULTS

We studied 14 patients, 57% were women. The average age at diagnosis was 9 years, headache was the most common reason for consultation. In all patients, papilledema was found in the fundus and neuroimaging didn´t find alterations. Optical coherence tomography has been carried out in 78.5% of the sample, > 80% of patients showed thickening of the retinal nerve fiber layer. All patients had a high cerebrospinal fluid opening pressure (>25 cmH2O). 57% of patients required treatment with acetazolamide, a carbonic anhydrase inhibito. In all patients the resolution was complete, however almost 30% of them have presented recurrences during follow-up.

CONCLUSIONS

In recent years there has been an increase in the incidence of this entity, making early diagnosis and treatment essential to avoid possible irreversible damage.

摘要

引言

特发性颅内高压(IIH)或良性颅内高压是儿童期的一种罕见疾病。儿科患者的临床表现差异很大,在年龄较小的患者中表现更不具特异性。

患者与方法

对一家三级医院神经儿科病房在过去八年(2016 - 2023年)诊断为IIH的患者进行了一项回顾性描述性研究。在本研究中,分析了每个病例的临床流行病学特征以及所采取的诊断治疗过程。

结果

我们研究了14例患者,其中57%为女性。诊断时的平均年龄为9岁,头痛是最常见的就诊原因。所有患者眼底均发现视乳头水肿,神经影像学检查未发现异常。78.5%的样本进行了光学相干断层扫描,>80%的患者显示视网膜神经纤维层增厚。所有患者脑脊液初压均较高(>25 cmH₂O)。57%的患者需要使用碳酸酐酶抑制剂乙酰唑胺进行治疗。所有患者病情均完全缓解,但几乎30%的患者在随访期间出现复发。

结论

近年来,该疾病的发病率有所上升,因此早期诊断和治疗对于避免可能的不可逆损害至关重要。

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