| Title | Pseudotumor cerebri in children. | | Author(s) | Phillips PH, Repka MX, Lambert SR | | Institution | Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-9009, USA. | | Source | J AAPOS 1998 Feb; 2(1):33-8. | | MeSH | Adolescent
Age Distribution
Child
Child, Preschool
Female
Humans
Intracranial Pressure
Male
Perimetry
Pseudotumor Cerebri
Vision Disorders
Visual Acuity
Visual Fields
| | Abstract | PURPOSE: Demographic and outcome data in the era of modern neuroimaging are needed to describe pseudotumor cerebri in children.
METHODS: We reviewed the medical records of children less than 18 years old who were diagnosed with pseudotumor cerebri between 1977 and 1997. We defined pseudotumor cerebri as (1) increased intracranial pressure, (2) normal or small ventricles, and (3) normal cerebrospinal fluid composition. The condition might be idiopathic or the result of a nontumor etiology.
RESULTS: Thirty-seven patients had an initial diagnosis of pseudotumor cerebri. Two patients were subsequently diagnosed with a central nervous system malignancy and were excluded from further analysis. The remaining 35 patients included 10 patients with idiopathic pseudotumor cerebri and 25 patients with disorders reported to be associated with pseudotumor cerebri. The mean age was 10.6 years with a range of 3 to 17 years. Twenty patients (57%) were female and 13 patients (37%) were obese. At presentation 4 patients had a visual acuity less than 20/40 in the best eye and 10 patients had visual field deficits. Seventeen patients (49%) had cranial nerve deficits, all of which resolved with normalization of the intracranial pressure. Follow-up data were obtained on 30 patients. Only one patient had a final visual acuity less than 20/40 in the best eye, whereas six patients had residual visual field deficits. Ten patients (33%) had optic nerve atrophy.
CONCLUSIONS: There was no gender predominance, and associated etiologic factors were common in these children with pseudotumor cerebri. Permanent visual loss occurs in some children with pseudotumor cerebri. Quantitative perimetry and optic nerve examination were more sensitive than visual acuity determination in detecting damage to the visual sensory system. In rare instances the patient diagnosed with pseudotumor cerebri will be found after extended follow-up to harbor an intracranial neoplasm. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 10532364 |
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