E-ISSN 1858-8360 | ISSN 0256-4408
 

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Idiopathic intracranial hypertension in children: Diagnostic and management approach.

Abdulrahman Albakr, Muddathir H Hamad, Ali H Alwadei, Fahad A Bashiri, Hamdy H Hassan, Hiyam Idris, Saeed Hassan, Taim Muayqil, Ikhlass Altweijri, Mustafa A Salih.

Abstract
Idiopathic intracranial hypertension (IIH) is a rare neurological disorder in children. It is characterized by raised intracranial pressure (ICP) in the absence of brain parenchymal lesion, vascular malformations, hydrocephalus, or central nervous system (CNS) infection. The diagnosis is usually confirmed by high opening pressure of cerebrospinal fluid (CSF) with exclusion of secondary causes of intracranial hypertension. If not treated properly, it may lead to severe visual dysfunction. Here we review the etiology, clinical presentation, diagnostic criteria and management of IIH in children through illustration of the clinical and radiological presentation of a 13-year-old overweight girl who presented with severe headache, diplopia and bilateral papilledema. Otherwise, she had unremarkable neurological and systemic examinations. Lumbar puncture showed a high CSF opening pressure (360-540 mmH2O). Her investigations showed normal complete blood count (CBC), normal renal, liver, and thyroid function tests. Cerebrospinal fluid (CSF) and blood chemistry were unremarkable. Magnetic resonant image (MRI) of the brain demonstrated empty sella turcica, tortuous optic nerves, and flattening of the posterior sclera. Magnetic resonant venography (MRV) showed focal narrowing of the distal transverse sinuses and absence of venous sinus thrombosis. She required treatment with acetazolamide and prednisolone. With medical treatment, weight reduction, and exercise, our patient had a remarkable improvement in her symptoms with resolution of papilledema in two months. This review highlights the importance of early recognition and management of IIH to prevent permanent visual loss.

Key words: Child; Idiopathic intracranial hypertension; Primary intracranial hypertension; Pseudo tumor cerebri; Secondary intracranial hypertension


 
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Pubmed Style

Albakr A, Hamad MH, Alwadei AH, Bashiri FA, Hassan HH, Idris H, Hassan S, Muayqil T, Altweijri I, Salih MA. Idiopathic intracranial hypertension in children: Diagnostic and management approach.. Sudan J Paed. 2016; 16(2): 67-76.


Web Style

Albakr A, Hamad MH, Alwadei AH, Bashiri FA, Hassan HH, Idris H, Hassan S, Muayqil T, Altweijri I, Salih MA. Idiopathic intracranial hypertension in children: Diagnostic and management approach.. http://www.sudanjp.com/?mno=280621 [Access: September 22, 2019].


AMA (American Medical Association) Style

Albakr A, Hamad MH, Alwadei AH, Bashiri FA, Hassan HH, Idris H, Hassan S, Muayqil T, Altweijri I, Salih MA. Idiopathic intracranial hypertension in children: Diagnostic and management approach.. Sudan J Paed. 2016; 16(2): 67-76.



Vancouver/ICMJE Style

Albakr A, Hamad MH, Alwadei AH, Bashiri FA, Hassan HH, Idris H, Hassan S, Muayqil T, Altweijri I, Salih MA. Idiopathic intracranial hypertension in children: Diagnostic and management approach.. Sudan J Paed. (2016), [cited September 22, 2019]; 16(2): 67-76.



Harvard Style

Albakr, A., Hamad, . M. H., Alwadei, . A. H., Bashiri, . F. A., Hassan, . H. H., Idris, . H., Hassan, . S., Muayqil, . T., Altweijri, . I. & Salih, . M. A. (2016) Idiopathic intracranial hypertension in children: Diagnostic and management approach.. Sudan J Paed, 16 (2), 67-76.



Turabian Style

Albakr, Abdulrahman, Muddathir H Hamad, Ali H Alwadei, Fahad A Bashiri, Hamdy H Hassan, Hiyam Idris, Saeed Hassan, Taim Muayqil, Ikhlass Altweijri, and Mustafa A Salih. 2016. Idiopathic intracranial hypertension in children: Diagnostic and management approach.. Sudanese Journal of Paediatrics, 16 (2), 67-76.



Chicago Style

Albakr, Abdulrahman, Muddathir H Hamad, Ali H Alwadei, Fahad A Bashiri, Hamdy H Hassan, Hiyam Idris, Saeed Hassan, Taim Muayqil, Ikhlass Altweijri, and Mustafa A Salih. "Idiopathic intracranial hypertension in children: Diagnostic and management approach.." Sudanese Journal of Paediatrics 16 (2016), 67-76.



MLA (The Modern Language Association) Style

Albakr, Abdulrahman, Muddathir H Hamad, Ali H Alwadei, Fahad A Bashiri, Hamdy H Hassan, Hiyam Idris, Saeed Hassan, Taim Muayqil, Ikhlass Altweijri, and Mustafa A Salih. "Idiopathic intracranial hypertension in children: Diagnostic and management approach.." Sudanese Journal of Paediatrics 16.2 (2016), 67-76. Print.



APA (American Psychological Association) Style

Albakr, A., Hamad, . M. H., Alwadei, . A. H., Bashiri, . F. A., Hassan, . H. H., Idris, . H., Hassan, . S., Muayqil, . T., Altweijri, . I. & Salih, . M. A. (2016) Idiopathic intracranial hypertension in children: Diagnostic and management approach.. Sudanese Journal of Paediatrics, 16 (2), 67-76.





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