Lorrot M, Bader-Meunier B, Sébire G, Dommergues J P
Service de pédiatrie générale, hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
Arch Pediatr. 1999 Jan;6(1):40-2. doi: 10.1016/s0929-693x(99)80071-2.
Benign intracranial hypertension is due to an increased intracranial pressure of unknown cause. The initial symptoms, complications and associations with medical conditions are discussed.
A 6-year-old girl developed symptoms of benign intracranial hypertension following reduction of oral corticosteroid therapy. Laboratory studies and head-computed tomographic scan were normal. Examination of the optic discs showed bilateral papilledema and the cerebrospinal fluid pressure was increased. The patient was given prednisone therapy 1 mg/kg daily initially, associated with acetazolamide, and removal of 25 mL of cerebrospinal fluid. All the symptoms resolved and the treatment was gradually decreased. The child developed no further visual failure.
Benign intracranial hypertension with the risk of permanent visual loss is a complication underrecognized in children. All patients receiving large doses of the corticosteroids who complain of headache or blurring vision, particularly following a reduction of corticosteroid dosage, should have an ophtalmoscopic examination to exclude this complication.
良性颅内高压是由不明原因的颅内压升高引起的。本文讨论了其初始症状、并发症以及与疾病的关联。
一名6岁女孩在口服皮质类固醇治疗减量后出现良性颅内高压症状。实验室检查和头部计算机断层扫描均正常。视盘检查显示双侧视乳头水肿，脑脊液压力升高。患者最初接受每日1毫克/千克的泼尼松治疗，并联合乙酰唑胺治疗，同时抽取25毫升脑脊液。所有症状均消失，治疗逐渐减量。该患儿未再出现视力减退。
伴有永久性视力丧失风险的良性颅内高压是儿童中未被充分认识的一种并发症。所有接受大剂量皮质类固醇治疗且主诉头痛或视力模糊的患者，尤其是在皮质类固醇剂量减量后，均应进行眼底检查以排除该并发症。
