Research Article

Retrospective Evaluation of Children With Pseudotumor Cerebri: A Single Center Experience

10.4274/atfm.galenos.2021.27879

  • Miraç Yıldırım

Received Date: 12.05.2021 Accepted Date: 02.06.2021 J Ankara Univ Fac Med 2021;74(3):283-288

Objectives:

Pseudotumor cerebri is a rare neurological condition in which signs of increased intracranial pressure are observed and there are no intracranial space-occupying pathologies. The aim of our study is to determine the demographic characteristics, diagnosis, treatments and prognosis of patients with pseudotumor cerebri.

Materials and Methods:

The data of 15 patients (9 girls, 6 boys) who were followed up with the diagnosis of pseudotumor cerebri between September 2017 and March 2019 in a tertiary training and research hospital pediatric neurology outpatient clinic were retrospectively evaluated.

Results:

The mean age of the patients was 10.26±4.75 years (range: 1-16 years). The most common signs and symptoms during the first admission were papilledema , headache, nausea-vomiting, weakness, blurred vision and double vision. Brain magnetic resonance imaging (MRI) was performed in all patients. Supporting findings of increased intracranial pressure were detected in three patients. The mean cerebrospinal fluid inlet pressure was 306±75 mmH2O (range: 260-470 mmH2O). Etiologically, the use of growth hormone (n=2), Down syndrome (n=1), Guillain-Barré syndrome (n=1), familial Mediterranean fever (n=1), Chiari malformation type 1 (n=1), acute lymphoblastic leukemia (n=1), vitamin A deficiency (n=1), obesity (n=1) and MODY tip 3 (n=1) were detected. Acetazolamide was started in all patients as initial therapy. Nine of 15 patients had full recovery, five of 15 patients had significant improvement in papilledema findings, and one of 15 patients had partial improvement. None of the patients developed permanent vision loss or visual field defect. No recurrence was observed in any patient after treatment discontinuation or during treatment.

Conclusion:

Pseudotumor cerebri is more common in childhood, especially in the postpubertal period. Obesity is a rare cause in childhood. An etiological cause that may cause pseudotumor cerebri can be detected in more than half of the pediatric patients, and the use of growth hormone was the most common in our study. Pseudotumor cerebri is a rare disease that requires long-term treatment and follow-up, but the outcome is generally well in patients who are diagnosed early, receive particular treatment and comply well with treatment.

Keywords: Pseudotumor Cerebri, Papilledema, Childhood, Treatment

Full Text (Turkish)