6,632 results on '"Pseudotumor cerebri"'
Search Results
2. Operative Procedures vs. Endovascular Neurosurgery for Untreated Pseudotumor Trial (OPEN-UP)
- Author
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Barrow Neurological Institute
- Published
- 2024
3. Biomarkers in the Etiology of Idiopathic Intracranial Hypertension (BEHIND)
- Published
- 2024
4. Multifocal Chromatic Pupilloperimetry in Patients With Pseudotumor Cerebri and Healthy Subjects.
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Dr. Ygal Rotenstreich, Head of ElectrophisiologyClinic and Retinal Research Laboratory
- Published
- 2024
5. A Trial to Determine the Efficacy and Safety of Presendin in IIH (IIH EVOLVE)
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Premier Research Group plc, University Hospitals Birmingham Neuro Ophthalmology Reading Centre, Birmingham, UK, and Iowa Visual Field Reading Centre, Iowa, USA
- Published
- 2024
6. Exploratory Study on the Efficacy and Safety of Semaglutide for Idiopathic Intracranial Hypertension Treatment
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Ji Xunming,MD,PhD, Principal Investigator
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- 2024
7. Current Treatment Methods of Idiopathic Intracranial Hypertension
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Mohamed Ahmed Mohamed Mansour, Doctor
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- 2024
8. Evaluating Raised Intracranial Pressure Using MR Elastography
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National Eye Institute (NEI) and John J Chen, Principal Investigator
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- 2024
9. Axial Length and Central Corneal Thickness in Benign Intracranial Hypertension
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Andrew Lawton, MD, Physician
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- 2024
10. Evaluation of the audiovestibular system before and after treatment in patients with Idiopathic intracranial hypertension.
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Karaketir, Semih, Berkiten, Güler, Tutar, Belgin, Akan, Onur, Kumral, Tolgar Lütfi, Sari, Hüseyin, Atar, Yavuz, Göker, Ayşe Enise, Ahmed, İsmail Abdullahi, Çelik, Cem, and Uyar, Yavuz
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INTRACRANIAL hypertension , *ACOUSTIC reflex , *INNER ear , *VESTIBULAR apparatus , *VESTIBULAR nerve - Abstract
AbstractBackgroundAims/ObjectivesMaterial and MethodsResultsConclusionSignificanceIdiopathic intracranial hypertension (IIH) can affect both hearing and balance due to increased inner ear pressure.This study aimed to evaluate the impact of increased inner ear pressure on hearing and balance in patients with IIH using auditory and vestibular tests.Twenty-four IIH patients and 28 healthy controls underwent oVEMP, pure tone audiometry, tympanometry, and acoustic reflex tests pre-lumbar punctures. IIH patients received acetazolamide. Pre- and post-treatment results, tinnitus, and vertigo scores were compared. Post-treatment oVEMP and audiometry results were compared between groups.Pre-treatment oVEMP showed a significant left N1 latency difference (
p = 0.049). Post-treatment, left ear amplitude (p = 0.035) and both ear amplitude ratios (p = 0.044 andp = 0.047) increased significantly. Audiometry had no significant changes (p < 0.05). Tinnitus and vertigo scores decreased significantly (p ≤ 0.001).Prolonged oVEMP latency suggests IIH may impact the brain stem and vestibular nerve, while increased amplitude values indicate peripheral vestibular involvement. IIH affects hearing across all frequencies, especially at 4000 Hz, impacting both hearing and balance.Understanding the effects of IIH on auditory and vestibular functions can guide effective treatments, improving quality of life for patients by addressing both hearing and balance issues. [ABSTRACT FROM AUTHOR]- Published
- 2024
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11. Idiopathic intracranial hypertension and obstetric and neonatal outcomes: A 1:20 matched study from a population database.
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Amikam, Uri, Baghlaf, Haitham, Badeghiesh, Ahmad, Brown, Richard, and Dahan, Michael H.
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INTRACRANIAL hypertension , *PREGNANCY outcomes , *PREMATURE labor , *PREGNANT women , *CESAREAN section , *ECLAMPSIA - Abstract
Objective: Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, is a common pathology in reproductive‐aged women, although data regarding pregnancy outcomes are scarce. In the present study, we aimed to compare pregnancy and perinatal outcomes between women who suffered from IIH to those who did not. Methods: A retrospective cohort study using the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample. All pregnant women who delivered or had a maternal death in the US (2004–2014) were included. Women with an ICD‐9 diagnosis of IIH before or during pregnancy were matched to controls without IIH according to age, race, insurance type, and income quartile, in a 1:20 ratio. Pregnancy, delivery, and neonatal outcomes were compared between the two groups. Results: Overall, 9 096 788 deliveries were identified. Of these, 1454 women (0.016%) had a diagnosis of IIH (study group) and were compared to 29 080 women without IIH (control group). Women with IIH, compared to those without, were more likely to be obese (body mass index >30 kg/m2) and suffer from pregestational diabetes mellitus and chronic hypertension (P < 0.001, all). After adjusting for confounders, patients in the IIH group, compared to those without, had a higher rate of pregnancy‐induced hypertension (aOR 1.82, 95% CI: 1.57–2.1, P < 0.001), pre‐eclampsia (aOR 1.98, 95% CI: 1.61–2.45, P < 0.001), preterm delivery (aOR 1.88, 95% CI: 1.59–2.23, P < 0.001), CD (aOR 2.41, 95% CI: 2.12–2.73, P < 0.001), wound complications (aOR 3.2, 95% CI: 1.89–5.42, P < 0.001), and congenital anomalies (aOR 2.18, 95% CI: 1.4–3.4, P < 0.001). Conclusion: Women with IIH had a higher incidence of obstetrical complications, including preterm deliveries, hypertensive disorders of pregnancy, and congenital anomalies. Synopsis: Women with IIH had a higher incidence of obstetrical complications, including preterm deliveries, hypertensive disorders of pregnancy, and congenital anomalies. [ABSTRACT FROM AUTHOR]
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- 2024
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12. The relationship between body mass index and cerebrospinal fluid pressure in children with pseudotumor cerebri.
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Çağ, Yakup, Sağer, Safiye Güneş, Akçay, Merve, Kaytan, İsmail, Söbü, Elif, Erdem, Aydan, and Akın, Yasemin
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RISK assessment , *BODY mass index , *INTRACRANIAL hypertension , *INTRACRANIAL pressure , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *MEDICAL records , *ACQUISITION of data , *CHILDHOOD obesity , *CEREBROSPINAL fluid , *DISEASE risk factors , *DISEASE complications , *CHILDREN - Abstract
Background: Childhood obesity has become a major global health problem. Obesity is associated with major health problems, such as diabetes, hypertension, dyslipidemia, cardiovascular disease. Obesity is also considered a risk factor for Pseudotumor cerebri (PTC). The present study aimed to investigate the relationship between body mass index (BMI), and cerebrospinal fluid (CSF) pressure in patients with pseudotumor cerebri. Methods: A total of 48 children diagnosed with PTC, who were aged < 18 years and followed up in the pediatric clinic were included in the retrospective study. National BMI percentile curves were used for reference. We investigated statistically the relationship between BMI, clinical and laboratory results, and CSF pressure in patients. Results: Of total patients 27 were female (56.25%) and 21 were male (43.75%). With regard to the BMI percentile, 20 (41.67%) were overweight or obese. CSF pressure was higher in overweight and obese patients compared to children with BMI in normal ranges (p < 0.05). A statistically significant positive correlation was also observed between BMI and CSF pressure values and between monocyte and CSF values (p < 0.05). Conclusions: The results of the present study indicate a direct relationship between CSF pressure and BMI in children with PTC. Appropriate diet, exercise, and medical treatment in overweight and obese children can make a significant contribution to the treatment of PTC. Additionally, a significant correlation was observed between CSF pressure and monocyte levels. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Isolated Intracranial Hypertensions as Onset of Myelin Oligodendrocyte Glycoprotein Antibody Disease.
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Papetti, Laura, Moltoni, Giulia, Longo, Daniela, Monte, Gabriele, Dellepiane, Francesco, Pro, Stefano, Bracaglia, Giorgia, Ruscitto, Claudia, Verrotti, Alberto, and Valeriani, Massimiliano
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MYELIN oligodendrocyte glycoprotein , *INTRACRANIAL hypertension , *POSTVACCINAL encephalitis , *OPTIC neuritis , *INTRACRANIAL pressure - Abstract
Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is characterized by multiple phenotypic conditions such as acute disseminated encephalomyelitis, optic neuritis, and myelitis. MOGAD's spectrum is expanding, with potential symptoms of increased intracranial pressure that are similar to idiopathic intracranial hypertension (IIH). We report a boy with new-onset continuous headache and a brain MRI at onset suggesting idiopathic intracranial hypertension (IIH). The patient showed resistance to treatment with acetazolamide and, after one month, developed optic neuritis in the left eye. Laboratory tests documented positive MOG antibodies (anti-MOG) in the serum. The final diagnosis was MOGAD, with the initial symptoms resembling IIH. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Characterisation and Visual Outcomes of Fulminant Idiopathic Intracranial Hypertension: A Narrative Review.
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Shaia, Jacqueline K., Markle, Jonathan, Das, Nikhil, Singh, Rishi P., Talcott, Katherine E., and Cohen, Devon A.
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INTRACRANIAL hypertension , *OPTIC disc edema , *CHILD patients , *BODY mass index , *CRANIAL nerves , *VISION disorders - Abstract
Fulminant idiopathic intracranial hypertension (IIH) is a rapid vision-degrading presentation of IIH with limited published studies. This study composed a narrative review of fulminant IIH with the aim of better characterising fulminant IIH presentation and visual outcomes. SCOPUS and PubMed were searched for papers referencing IIH, benign intracranial hypertension, or pseudotumour cerebri. Abstracts were screened for rapid degradation in vision. All studies were required to meet both the modified Dandy and fulminant IIH criteria. Thirty-six studies met the inclusion criteria. Demographics, treatments, and visual outcome data were collected. Case studies made up 69% of the studies and 31% were case series. In total, 72 patients with fulminant IIH were reported, of which 23.6% were paediatric and 96% were female. Surgical intervention occurred in 85% of patients. Anaemia was present in 11% of patients and 85.7% of paediatric patients had a sixth cranial nerve palsy. In conclusion, we propose the following practice guidelines to assist in diagnosing and treating fulminant IIH patients: 1) patients who present with optic disc oedema require urgent visual field testing to evaluate for vision loss; 2) a paediatric patient presenting with a sixth cranial nerve palsy should have a comprehensive eye examination; 3) fulminant IIH can occur in patients with a normal body mass index; and 4) anaemia should be tested for in the setting of fulminant IIH. As little is known about the optimal treatment mechanisms for this presentation, multi-institutional and international collaborations will be a critical step for future research. [ABSTRACT FROM AUTHOR]
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- 2024
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15. The Relationship between Idiopathic Intracranial Hypertension and Obstructive Sleep Apnea: Is Obesity the Only Mediating Factor between the Two?
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DEVECİ, Şule and KABELOĞLU, Vasfiye
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OBESITY complications , *RISK assessment , *CROSS-sectional method , *BODY mass index , *INTRACRANIAL hypertension , *MULTIPLE regression analysis , *QUESTIONNAIRES , *SEX distribution , *AGE distribution , *SLEEP apnea syndromes , *OBESITY , *DISEASE risk factors , *DISEASE complications - Abstract
Aim: This study aimed to investigate the possible reciprocal relationship between idiopathic intracranial hypertension (IIH) and obstructive sleep apnea (OSA). Material and Methods: This cross-sectional study was conducted from October 2023 to February 2024. Patients with IIH and age and gender-matched controls without IIH were included. Information on age, gender, comorbidities, smoking, and alcohol consumption was recorded. Body mass index (BMI) was calculated, and a BMI ≥30 was considered obese. Berlin questionnaire and STOP-BANG questionnaire were administered to all participants. High risk for OSA was determined if participants responded affirmatively to at least three out of the eight questions on the STOP-BANG questionnaire, or if two out of the three categories showed positive results on the Berlin questionnaire. Results: Sixty patients with IIH and 120 controls participated. There were no significant differences between groups regarding age (p=0.437) and gender distribution (p=0.716). The percentage of obese subjects was significantly higher in the IIH group (p<0.001). The Berlin and STOP-BANG results showed that the IIH group had higher risks for OSA than the control group. Multivariate logistic regression analysis revealed obesity as the only factor independently associated with high-risk classification with the Berlin questionnaire. In the STOP-BANG survey, higher age, male gender, obesity, and hyperlipidemia were independently related to high-risk classification. Conclusion: Obesity is a common risk factor for both OSA and IIH. The coexistence of OSA and IIH may cause increased morbidity and mortality rates in both diseases. Therefore, we recommend that patients with IIH be screened for OSA risk. [ABSTRACT FROM AUTHOR]
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- 2024
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16. Coronavirus Disease 2019-Related Fulminant Idiopathic Intracranial Hypertension.
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Çalışkan, Burcu, Canbal, Abdullah, Güven, Ahmet Sami, Bitirgen, Gülfidan, Erdi, Mehmet Fatih, and Çaksen, Hüseyin
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PHYSICAL diagnosis ,VISION disorders ,ACETAZOLAMIDE ,MANNITOL ,FUROSEMIDE ,INTRACRANIAL hypertension ,EYE movement measurements ,IMMUNOGLOBULINS ,SURGICAL anastomosis ,TREATMENT effectiveness ,VENOGRAPHY ,INTRAVENOUS therapy ,VISUAL acuity ,COVID-19 ,PAPILLEDEMA ,DISEASE complications ,SYMPTOMS - Abstract
Idiopathic intracranial hypertension or pseudotumor cerebri syndrome (PTCS) is defined as an increase in intracranial pressure (ICP) without an identifiable and/or structural cause or abnormal cerebrospinal fluid content. The most common symptoms of PTCS include headache, vomiting, pulsatile tinnitus, blurred vision, and diplopia. In 2 to 3% of PTCS patients, severe and rapidly progressive vision loss may develop within 1 month since symptoms begin; this clinical condition is usually defined as fulminant idiopathic intracranial hypertension (FIIH). This study presented a patient admitted to the hospital with headache and blurred vision, who also had high severe acute respiratory syndrome coronavirus 2 infections total antibody level and was treated with a lumboperitoneal shunt due to medical treatment-resistant increased ICP. We also reviewed similar cases previously reported in the literature. To the best of our knowledge, no children affected with coronavirus 2019 related to FIIH and requiring surgical treatment have been yet reported in the literature. [ABSTRACT FROM AUTHOR]
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- 2024
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17. The diagnostic value of MRI findings in pediatric idiopathic intracranial hypertension: a case-control study.
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Seilanian Toosi, Farrokh, Hashemi, Narges, Emadzadeh, Maryam, Hassan Nejad, Ehsan, Payandeh, Asma, Tavakkolizadeh, Nahid, Akhondian, Javad, Ashrafzadeh, Farah, Beiraghi Toosi, Mehran, Shahmoradi, Yousef, Pourzal, MohammadReza, Kazemi, Seyed Amirhossein, Moodi Ghalibaf, AmirAli, and Beizaei, Behnam
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INTRACRANIAL hypertension , *SUBARACHNOID space , *MAGNETIC resonance imaging , *CASE-control method , *OPTIC nerve , *INTRACRANIAL pressure - Abstract
Background: Idiopathic intracranial hypertension (IIH) is a rare medical condition in children. Based on the different radiological findings reported in various studies in pediatric IIH, this study was conducted to determine the diagnostic value of MRI findings in diagnosing IIH in children. Methods: In this retrospective study, the medical records of all children aged 1 to 18 years who visited Ghaem Hospital in Mashhad, Iran, between 2012 and 2022 and were diagnosed with IIH were gathered. Forty-nine cases of children with IIH and 48 control cases of children with the first unprovoked seizure with no indications of increased intracranial pressure for comparison were selected. Patient demographic information and MRI findings were extracted. The comparison between different MRI findings in the case and control groups was conducted using statistical tests. Results: In the case group, the mean diameter of the subarachnoid space expansion around the optic nerve was 5.96 ± 1.21, compared to 4.79 ± 0.33 in the control group, with statistically significant difference (P < 0.001). All the patients with flattening of the posterior globe or transverse sinus stenosis were in the case group, and the frequency of these findings in the case group was significantly higher than in the control group (P < 0.001). The majority of patients (95.5%) classified under category 3 and 4 of empty sella were part of the case group, and the statistical test results indicated a significant difference between the two groups (P < 0.001). The optic nerve sheath diameter cut-off of 5.35 mm, when used for expansion of the subarachnoid space around the optic nerve, with a sensitivity of 82% and a specificity of 100% in diagnosing IIH. Conclusion: The most reliable diagnostic indicators for diagnosing IIH in children are perioptic subarachnoid space expansion with high sensitivity, and posterior globe flattening and transverse sinus stenosis with high specificity. [ABSTRACT FROM AUTHOR]
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- 2024
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18. The relationship between body mass index and cerebrospinal fluid pressure in children with pseudotumor cerebri
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Yakup Çağ, Safiye Güneş Sağer, Merve Akçay, İsmail Kaytan, Elif Söbü, Aydan Erdem, and Yasemin Akın
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Pseudotumor Cerebri ,Obesity ,Body Mass Index ,Cerebrospinal Fluid Pressure ,Children ,Pediatrics ,RJ1-570 - Abstract
Abstract Background Childhood obesity has become a major global health problem. Obesity is associated with major health problems, such as diabetes, hypertension, dyslipidemia, cardiovascular disease. Obesity is also considered a risk factor for Pseudotumor cerebri (PTC). The present study aimed to investigate the relationship between body mass index (BMI), and cerebrospinal fluid (CSF) pressure in patients with pseudotumor cerebri. Methods A total of 48 children diagnosed with PTC, who were aged
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- 2024
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19. Post Market Clinical Follow-up of CODMAN CERTAS Programmable Valve
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- 2023
20. Astronaut Vision Issues in a Ground Analog Population: Polycystic Ovary Syndrome (PCOS)
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University of Texas, Mayo Clinic, University of Florida, University of North Carolina, Coastal Eye Associates, and Scott M. Smith, Nutritionist, Manager for Nutritional Biochemistry
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- 2023
21. Clinical profile and treatment outcomes of idiopathic intracranial hypertension: a multicenter study from Korea
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Kyung-Hee Cho, Seol-Hee Baek, Sung-Hee Kim, Byung-Su Kim, Jong-Hee Sohn, Min Kyung Chu, Mi-Kyoung Kang, Hee Jung Mo, Sang-Hwa Lee, Hong-Kyun Park, Soohyun Cho, Sun-Young Oh, Jong-Geun Seo, Wonwoo Lee, Ju-Young Lee, Mi Ji Lee, and Soo-Jin Cho
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Asian ,Intracranial hypertension ,Intracranial pressure ,Papilledema ,Pseudotumor cerebri ,Medicine - Abstract
Abstract Background Currently, there is a relative lack of detailed reports regarding clinical presentation and outcome of idiopathic intracranial hypertension in Asians. This study aims to describe the clinical features and treatment outcomes of Korean patients with idiopathic intracranial hypertension. Methods We prospectively recruited patients with idiopathic intracranial hypertension from one hospital and retrospectively analyzed the medical records of 11 hospitals in Korea. We collected data regarding preceding medical conditions or suspected medication exposure, headache phenotypes, other associated symptoms, detailed neuroimaging findings, treatments, and outcomes after 1–2 and 3–6 months of treatment. Results Fifty-nine (83.1% women) patients were included. The mean body mass index was 29.11 (standard deviation, 5.87) kg/m2; only 27 patients (45.8%) had a body mass index of ≥ 30 kg/m2. Fifty-one (86.4%) patients experienced headaches, patterns of which included chronic migraine (15/51 [29.4%]), episodic migraine (8/51 [15.7%]), probable migraine (4/51 [7.8%]), chronic tension-type headache (3/51 [5.9%]), episodic tension-type headache (2/51 [3.9%]), probable tension-type headache (2/51 [3.9%]), and unclassified (17/51 [33.3%]). Medication overuse headache was diagnosed in 4/51 (7.8%) patients. After 3–6 months of treatment, the intracranial pressure normalized in 8/32 (25.0%), improved in 17/32 (53.1%), no changed in 7/32 (21.9%), and worsened in none. Over the same period, headaches remitted or significantly improved by more than 50% in 24/39 patients (61.5%), improved less than 50% in 9/39 (23.1%), and persisted or worsened in 6/39 (15.4%) patients. Conclusion Our findings suggest that the features of Asian patients with idiopathic intracranial hypertension may be atypical (i.e., less likely obese, less female predominance). A wide spectrum of headache phenotypes was observed. Medical treatment resulted in overall favorable short-term outcomes; however, the headaches did not improve in a small proportion of patients.
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- 2024
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22. Idiopathic Intracranial Hypertension With Unusual Presentation in an Adolescent Girl: A Case Report
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Afagh Hassanzadeh Rad and Vahid Aminzadeh
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pseudotumor cerebri ,idiopathic intracranial hypertension ,child ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Background: Idiopathic intracranial hypertension (IIH) or pseudotumor cerebri is a rare disorder. Regarding the latest diagnostic criteria for this disorder, we present a rare case of IIH. Case presentation: The case was an 11-year-old girl referred to our center with generalized body pain and mild left-eye deviation with no other visual symptoms. She had a severe generalized pain especially in her back and prevertebral area. In the neurological examination, there was a mild left sixth nerve palsy and bilateral papilledema. We treated the patient with acetazolamide and to lumbar puncture, which reduced intracranial pressure. The generalized body pain was reduced gradually in ten days, eye deviation in three weeks, and papilledema in two months after treatment. Conclusion: Based on the serious complications of IIH, a thorough assessment of suspicious cases, including ophthalmoscopic examinations, is mandatory. Furthermore, clinicians should consider even rare and unknown specific symptoms in these patients.
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- 2024
23. Clinical profile and treatment outcomes of idiopathic intracranial hypertension: a multicenter study from Korea.
- Author
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Cho, Kyung-Hee, Baek, Seol-Hee, Kim, Sung-Hee, Kim, Byung-Su, Sohn, Jong-Hee, Chu, Min Kyung, Kang, Mi-Kyoung, Mo, Hee Jung, Lee, Sang-Hwa, Park, Hong-Kyun, Cho, Soohyun, Oh, Sun-Young, Seo, Jong-Geun, Lee, Wonwoo, Lee, Ju-Young, Lee, Mi Ji, and Cho, Soo-Jin
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STATISTICAL significance , *RESEARCH funding , *INTRACRANIAL hypertension , *HEADACHE , *TREATMENT effectiveness , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *LONGITUDINAL method , *MEDICAL records , *ACQUISITION of data , *RESEARCH , *DATA analysis software , *MIGRAINE - Abstract
Background: Currently, there is a relative lack of detailed reports regarding clinical presentation and outcome of idiopathic intracranial hypertension in Asians. This study aims to describe the clinical features and treatment outcomes of Korean patients with idiopathic intracranial hypertension. Methods: We prospectively recruited patients with idiopathic intracranial hypertension from one hospital and retrospectively analyzed the medical records of 11 hospitals in Korea. We collected data regarding preceding medical conditions or suspected medication exposure, headache phenotypes, other associated symptoms, detailed neuroimaging findings, treatments, and outcomes after 1–2 and 3–6 months of treatment. Results: Fifty-nine (83.1% women) patients were included. The mean body mass index was 29.11 (standard deviation, 5.87) kg/m2; only 27 patients (45.8%) had a body mass index of ≥ 30 kg/m2. Fifty-one (86.4%) patients experienced headaches, patterns of which included chronic migraine (15/51 [29.4%]), episodic migraine (8/51 [15.7%]), probable migraine (4/51 [7.8%]), chronic tension-type headache (3/51 [5.9%]), episodic tension-type headache (2/51 [3.9%]), probable tension-type headache (2/51 [3.9%]), and unclassified (17/51 [33.3%]). Medication overuse headache was diagnosed in 4/51 (7.8%) patients. After 3–6 months of treatment, the intracranial pressure normalized in 8/32 (25.0%), improved in 17/32 (53.1%), no changed in 7/32 (21.9%), and worsened in none. Over the same period, headaches remitted or significantly improved by more than 50% in 24/39 patients (61.5%), improved less than 50% in 9/39 (23.1%), and persisted or worsened in 6/39 (15.4%) patients. Conclusion: Our findings suggest that the features of Asian patients with idiopathic intracranial hypertension may be atypical (i.e., less likely obese, less female predominance). A wide spectrum of headache phenotypes was observed. Medical treatment resulted in overall favorable short-term outcomes; however, the headaches did not improve in a small proportion of patients. [ABSTRACT FROM AUTHOR]
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- 2024
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24. Idiopathic Intracranial Hypertension After Abrupt Cessation of Medication: A Case Report of Abrupt Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Cessation and Review of the Literature.
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Heckel, Brittany
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Purpose of Review: The purpose of this review is two-fold: (1) to discuss a case report of idiopathic intracranial hypertension (IIH) after abrupt cessation of a glucagon-like peptide-1 (GLP-1) receptor agonist with resultant rapid weight gain and (2) to review the literature regarding the potential role of GLP-1 receptor agonists in the treatment of IIH as well as potential pitfalls. Recent Findings: GLP-1 receptor agonists have become widely used to treat obesity. Obesity is a known risk factor for the development of IIH, though the precise pathophysiology is unclear. GLP-1 receptor agonists may help treat IIH by promoting weight loss, lipolysis of adipose tissue, and potentially decreasing the secretion of CSF, as was seen in rat models. Abrupt cessation of GLP-1 receptor agonists can result in regaining lost weight rapidly. In the case that we present, the patient stopped duraglutide abruptly due to lack of insurance coverage and regained the weight she had lost within a month. She subsequently developed IIH. Summary: GLP-1 receptor agonists have the potential to help treat IIH; however, this class of medication needs to be used carefully, as cessation of the medication and resultant rapid weight gain can result in IIH. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Interrelation Between Cerebrospinal Fluid Pressure, Intracranial Morphology and Venous Hemodynamics Studied by 4D Flow MRI.
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Schuchardt, Florian F., Krafft, Axel J., Miguel Telega, Lidia, Küchlin, Sebastian, Lagrèze, Wolf A., Demerath, Theo, Arnold, Philipp, Fung, Christian, Kraus, Luisa M., Hennemuth, Anja, Beck, Jürgen, Urbach, Horst, Weiller, Cornelius, and Harloff, Andreas
- Abstract
Purpose: To quantify the effects of CSF pressure alterations on intracranial venous morphology and hemodynamics in idiopathic intracranial hypertension (IIH) and spontaneous intracranial hypotension (SIH) and assess reversibility when the underlying cause is resolved. Methods: We prospectively examined venous volume, intracranial venous blood flow and velocity, including optic nerve sheath diameter (ONSD) as a noninvasive surrogate of CSF pressure changes in 11 patients with IIH, 11 age-matched and sex-matched healthy controls and 9 SIH patients, before and after neurosurgical closure of spinal dural leaks. We applied multiparametric MRI including 4D flow MRI, time-of-flight (TOF) and T2-weighted half-Fourier acquisition single-shot turbo-spin echo (HASTE). Results: Sinus volume overlapped between groups at baseline but decreased after treatment of intracranial hypotension (p = 0.067) along with a significant increase of ONSD (p = 0.003). Blood flow in the middle and dorsal superior sagittal sinus was remarkably lower in patients with higher CSF pressure (i.e., IIH versus controls and SIH after CSF leak closure) but blood flow velocity was comparable cross-sectionally between groups and longitudinally in SIH. Conclusion: We were able to demonstrate the interaction of CSF pressure, venous volumetry, venous hemodynamics and ONSD using multiparametric brain MRI. Closure of CSF leaks in SIH patients resulted in symptoms suggestive of increased intracranial pressure and caused a subsequent decrease of intracranial venous volume and of blood flow within the superior sagittal sinus while ONSD increased. In contrast, blood flow parameters from 4D flow MRI did not discriminate IIH, SIH and controls as hemodynamics at baseline overlapped at most vessel cross-sections. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Enhancing Diagnostic Accuracy Through Neuroimaging Revisions in Pediatric Pseudotumor Cerebri Syndrome: A Cross-Sectional Study.
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Masri, Amira, Al Ryalat, Nosaiba, Hadidy, Azmy, Al-Shakkah, Ashjan Ahmad, Ali, Majd, Al Jaberi, Mira, Shihadat, Raghad, Rayyan, Abdallah, AlMasri, Mohammad, and Abunameh, Lina
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INTRACRANIAL hypertension , *BRAIN imaging , *CROSS-sectional method , *CAVERNOUS sinus , *INTRACLASS correlation - Abstract
This cross-sectional study aimed to report all neuroimaging findings suggestive of raised intracranial pressure in children with pseudotumor cerebri syndrome (PTCS), before and after re-review by two neuroradiologists. We included 48 children aged <18 years diagnosed with PTCS between 2016 and 2021. Clinical and radiological data were obtained from their medical files. Two neuroradiologists independently re-reviewed all neuroimages, and the average of their assessments was compared with the initial neuroimaging reports; an additional review was done to analyze inter- and intraclass correlation. The initial neuroimaging reports showed under-reporting of findings, with only 26 of 48 (54.1%) patients identified with abnormal reports. After revision, the proportion of the reported findings increased to 44 of 48 (91.6%). Distention of the perioptic space was the most commonly reported finding after revision (36.5 of 48; 76%). Flattening of the posterior globe and empty sella were initially under-reported but improved after revision. Moreover, several findings suggestive of increased intracranial pressure not mandated by Friedman criteria were identified, such as narrowing of the Meckel cave, posterior displacement of the pituitary stalk, and narrowing of the cavernous sinus. Analysis of associations between neuroimaging findings and demographic and clinical characteristics yielded no statistically significant results. The inter- and intraclass correlation results demonstrated a significant agreement between raters and within each rater's assessment (P < 0.05). This study highlights the impact of image revision in enhancing PTCS diagnosis. Intra- and interclass correlations underscore the reliability of the review process, emphasizing the importance of meticulous image analysis in clinical practice. [ABSTRACT FROM AUTHOR]
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- 2024
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27. Neurofilament light chain is elevated in patients with newly diagnosed idiopathic intracranial hypertension: A prospective study.
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Svart, Katrine, Korsbæk, Johanne Juhl, Jensen, Rigmor Højland, Parkner, Tina, Knudsen, Cindy Søndersø, Hasselbalch, Steen Gregers, Hagen, Snorre Malm, Wibroe, Elisabeth Arnberg, Molander, Laleh Dehghani, and Beier, Dagmar
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INTRACRANIAL hypertension , *CYTOPLASMIC filaments , *SCOTOMA , *LONGITUDINAL method , *CEREBROSPINAL fluid , *PAPILLEDEMA - Abstract
Background: Idiopathic intracranial hypertension is a secondary headache disorder potentially causing visual loss. Neurofilament light chain is a candidate, prognostic biomarker, but further studies of neuronal biomarkers are needed. Our objective was to investigate neurofilament light chain in cerebrospinal fluid (cNfL) and plasma (pNfL), amyloid-beta 42 (Aβ-42), total-tau and phosphorylated-tau in cerebrospinal fluid in new-onset idiopathic intracranial hypertension. Methods: Prospective case-control study including new-onset idiopathic intracranial hypertension and age, sex and BMI matched controls. Biomarkers were compared between patients and controls and related to papilledema, visual fields and opening pressure. Results: We included 37 patients and 35 controls. Patients had higher age-adjusted cNfL (1.4 vs. 0.6 pg/mL, p-adjusted < 0.001), pNfL (0.5 vs. 0.3 pg/mL, p-adjusted < 0.001) and total-tau/Aβ-42 (0.12 vs. 0.11, p-adjusted = 0.039). Significant, positive linear correlations were found between cNfL, pNfL, total-tau/Aβ-42 and opening pressure. Patients with severe papilledema had elevated cNfL compared to mild-moderate papilledema (median cNfL: 4.3 pg/mL (3.7) versus 1.0 pg/mL (1.4), p-adjusted = 0.009). cNFL was inversely associated with perimetric mean deviation (r = −0.47, p-adjusted < 0.001). Conclusions: cNfL, pNfL and total-tau/Aβ-42 were elevated in new-onset idiopathic intracranial hypertension. cNfL was associated with severity of papilledema and visual field defects at diagnosis. This indicates early axonal damage. Neurofilament light chain is a candidate biomarker for disease severity. [ABSTRACT FROM AUTHOR]
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- 2024
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28. Case report: Association between PTEN-gene variant and an aggressive case of multiple dAVFs.
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Suzanna Jong-A-Liem, Glaucia, Martins Sarti, Talita Helena, Glasenapp dos Santos, Mariusi, Marcus, Luciano, Wuo-Silva, Raphael, Machado Baeta, Alex, de Campos Filho, José Maria, and Chaddad-Neto, Feres
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PTEN protein ,VENOUS thrombosis ,AUDITORY neuropathy ,AUTISM spectrum disorders ,MAGNETIC resonance imaging ,INTRACRANIAL hypertension ,HAMARTOMA - Abstract
Introduction: Mutations of the phosphatase and tensin homolog (PTEN) gene have been associated with a spectrum of disorders called PTEN hamartoma tumor syndrome, which predisposes the individual to develop various types of tumors and vascular anomalies. Its phenotypic spectrum includes Cowden syndrome (CS), Bannayan–Riley–Ruvalcaba syndrome (BRRS), Proteus syndrome, autism spectrum disorders (ASD), some sporadic cancers, Lhermitte–Duclos disease (LDD), and various types of associated vascular anomalies. Clinical presentation: A previously healthy 27-year-old woman was experiencing visual scintillating scotomas and mild chronic headaches for the past 2 years. The initial computed tomographic (CT) and magnetic resonance imaging (MRI) scans did not reveal any abnormalities, but the possibility of pseudotumor cerebri was considered. Furthermore, a cerebral angiogram showed a posterior fossa dural arteriovenous fistula (dAVF), which was initially treated through embolization. However, in spite of proper treatment, this patient experienced multiple recurrent dAVFs in different locations, requiring multiple embolizations and surgeries. Despite exhibiting altered cerebral perfusion and hemodynamics, the patient did not display any significant symptoms until she experienced a sudden stroke resulting from deep venous thrombosis, which was not associated with any medical procedures or medication use. A comprehensive analysis was performed due to the aggressive nature of the dAVFs. Surprisingly, exome sequencing of a blood sample revealed a PTEN gene variant in chromosome 10, indicative of Cowden syndrome. However, no tumors or other vascular lesions were detected in other systems that would constitute Cowden syndrome. Conclusion: The rapid formation of multiple and complex dAVFs, coupled with not meeting the criteria for any other PTEN-related syndrome, unequivocally leads to the presentation of a novel phenotype of the PTEN germline variant. [ABSTRACT FROM AUTHOR]
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- 2024
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29. Does a Healthy Weight Body Mass Index at Onset of Idiopathic Intracranial Hypertension Change the Outcomes? A United Kingdom Prospective Cohort Study.
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Thaller, Mark, Homer, Victoria, Abbott, Sally, Hazlehurst, Jonathan, Mollan, Susan P., and Sinclair, Alexandra J.
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Idiopathic intracranial hypertension (IIH) predominantly affects reproductive-aged females with obesity. However, the prevalence and impact of a healthy weight body mass index (BMI) at disease presentation is not known. This study aimed to evaluate the visual and headache outcomes stratified by the presenting BMI. This was a longitudinal prospective cohort study (IIH Life) based on a tertiary neuro-ophthalmology IIH service, University Hospitals Birmingham NHS Trust, United Kingdom, recruiting consecutive patients living with IIH between 2012 and 2021. Those with a presenting BMI were included. The outcome measures included visual outcomes of LogMAR visual acuity, Humphrey visual field perimetric mean deviation (PMD), optical coherence tomography (OCT) measurements, and headache outcomes of frequency, severity, and Headache Impact Test-6 score. Three hundred seventy-five people with IIH and a documented baseline BMI. About 3.7% of the entire cohort had a healthy weight BMI at IIH presentation and 15.5% BMI < 30 kg/m2. The baseline PMD was worse in patients without obesity; however, OCT papilloedema measures were similar. The presence of obesity was associated with a small but significant greater worsening in visual acuity but slower macular ganglion cell layer loss. There was no impact on PMD or papilloedema prognosis related to baseline obesity. The headache outcomes showed heterogeneity, with worse baseline headache frequency in patients with obesity. No BMI group was associated with worse headache outcomes. Patients with a healthy weight BMI or those without obesity at baseline make up a small proportion of IIH patients. BMI at presentation does not appear to influence long-term visual or headache outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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30. Apparent Diffusion Coefficient of the Optic Nerve Head in Idiopathic Intracranial Hypertension.
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Lama, Carine, Derakhshan, Jamal, Wilson, Bradley, Snyder, Douglas, Tang, Yunshuo, and Van Stavern, Gregory
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Idiopathic Intracranial Hypertension (IIH) is a condition in which patients have elevated intracranial pressure which does not have an apparent cause. To diagnose IIH, evaluation excluding other causes of elevated pressure must be performed. This typically includes magnetic resonance imaging (MRI) of the brain and venous sinuses. Despite there being known radiographic signs suggestive of IIH on MRI, there currently are no established correlations between radiographic findings and visual outcomes. Previous work revealed diffusion weighted imaging (DWI), a qualitative measurement on MRI, correlated with clinical findings (i.e presence and grade of papilloedema), but not visual outcomes. We hypothesized that the apparent diffusion coefficient (ADC), a quantitative value obtained during clinical MRI, may correlate with visual outcomes. We conducted a retrospective chart review to correlate findings on the ADC sequence on routine brain MRIs in patients with papilloedema with visual outcomes. In 49 patients with IIH, this study shows the ADC in the retrobulbar optic nerve to be 1,487 ± 559 × 10−6 mm2 /s, 15% lower than reported value of 1744 ± 413 in healthy controls. This suggests that there is true restricted diffusion in patients with IIH and papilloedema, as previously reported visually by MRI. However, there was no significant correlation with clinical outcomes of papilloedema grade, mean deviation on standard perimetry, and retinal nerve fibre layer (RNFL) on optical coherence tomography (OCT). We discuss reasons why the ADC measurement may be confounded by motion and partial volume and propose methods that may reduce these confounders for future studies. [ABSTRACT FROM AUTHOR]
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- 2024
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31. Persistent Elevation of Opening Pressure Despite Treatment and Symptom Resolution in Pediatric Intracranial Hypertension.
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Pabst, Lisa, Aylward, Brandon S., Rogers, David L., and Aylward, Shawn C.
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INTRACRANIAL hypertension , *OPTIC disc edema , *THERAPEUTICS , *SYMPTOMS , *BODY mass index , *LUMBAR puncture - Abstract
Currently no guidelines for repeating a lumbar puncture to guide management in primary intracranial hypertension (PIH) exist. An institutional database of patients 18 years and younger followed in the institution's pediatric intracranial hypertension clinic was examined for opening pressure changes in PIH at diagnosis, before medication wean, and following medication wean, as well as to examine whether measurements at the time of diagnosis differed between those with and without disease recurrence. Forty-two patients were included in this study; 36% were male and the mean age at diagnosis was 11.01 years. Treatment duration averaged 9.68 months in those without recurrence and 8.5 months in those with recurrence. Average body mass index percentile of patients with disease recurrence was 83.7 and 72.1 in those without recurrence (P = 0.16). Average opening pressure values of all patients at diagnosis, prewean, and postwean was 36.53 cm H 2 O, 30.7 cm H 2 O, and 31.1 cm H 2 O, respectively. There was no statistically significant difference in opening pressures across these time points (P = 0.14). The change in opening pressure from diagnosis to postwean was statistically significant with a reduction of 5.18 cm H 2 O (P = 0.04). There was no statistical difference between change in opening pressure at diagnosis versus postwean between those with and without recurrence (P = 0.17). This clinical observational study suggests that mean opening pressure measurements in patients with PIH remain elevated both before and after medication wean despite papilledema resolution and patient-reported PIH symptoms. Clinically, this suggests that other features such as signs of optic disc edema and symptoms should be used to inform a clinical determination of disease recurrence and treatment course. [ABSTRACT FROM AUTHOR]
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- 2024
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32. Idiopathic Intracranial Hypertension With Unusual Presentation in an Adolescent Girl: A Case Report.
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Rad, Afagh Hassanzadeh and Aminzadeh, Vahid
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TEENAGE girls , *INTRACRANIAL hypertension , *INTRACRANIAL pressure , *LUMBAR puncture , *PAPILLEDEMA - Abstract
Background: Idiopathic intracranial hypertension (IIH) or pseudotumor cerebri is a rare disorder. Regarding the latest diagnostic criteria for this disorder, we present a rare case of IIH. Case presentation: The case was an 11-year-old girl referred to our center with generalized body pain and mild left-eye deviation with no other visual symptoms. She had a severe generalized pain especially in her back and prevertebral area. In the neurological examination, there was a mild left sixth nerve palsy and bilateral papilledema. We treated the patient with acetazolamide and to lumbar puncture, which reduced intracranial pressure. The generalized body pain was reduced gradually in ten days, eye deviation in three weeks, and papilledema in two months after treatment. Conclusion: Based on the serious complications of IIH, a thorough assessment of suspicious cases, including ophthalmoscopic examinations, is mandatory. Furthermore, clinicians should consider even rare and unknown specific symptoms in these patients. [ABSTRACT FROM AUTHOR]
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- 2024
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33. Pseudotumor cerebri with status epilepticus in a child: A rare presentation of vitamin D deficiency.
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Pahari, Soumya, Kunwar, Prakash, Acharya, Subi, Rauniyar, Pallavi, and Sagar Bahadur, C. K.
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VITAMIN D deficiency , *INTRACRANIAL hypertension , *STATUS epilepticus , *VITAMIN deficiency , *ETIOLOGY of diseases , *EPILEPSY - Abstract
Key Clinical Message: Pseudotumor cerebri (PTC) encompasses a constellation of symptoms caused by elevated intracranial pressure of unclear etiology. Various associations have been described, rarely hypovitaminosis D. Vitamin D deficiency should be considered as a potential etiology of neurological manifestations like PTC and seizures in children. Early diagnosis and correction of vitamin D deficiency is key to preventing morbidity and achieving good outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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34. The Effect of an Anti-obesity Drug, Semaglutide, as Treatment in New-onset Idiopathic Intracranial Hypertension (IIH) Compared to Standard Weight Management (Dietician) With Regards to Change in Weight and Intracranial Pressure (IIH:DUAL)
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Rigshospitalet, Denmark, Odense University Hospital, University of Copenhagen, and Rigmor Højland Jensen, Professor in Neurology
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- 2023
35. Stenting Versus Neurosurgical Treatment of Idiopathic Intracranial Hypertension. (HYDROPTIC)
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- 2023
36. Intraoperative cone-beam computed tomography for catheter placement verification in pediatric hydrocephalus: technical note
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Krause, Matthias, Lagumdzija, Jasmina, Enzinger, Simon, Wittig, Jörn, Gaggl, Alexander, Metzger, Roman P., and Griessenauer, Christoph J.
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- 2024
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37. Pseudotumor cerebri in the paediatric population: clinical features, treatment and prognosis
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F. Labella Álvarez, J.A. Fernández-Ramos, R. Camino León, E. Ibarra de la Rosa, and E. López Laso
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Hipertensión intracraneal benigna ,Niño ,Hipertensión intracraneal idiopática ,Obesidad ,Pseudotumor cerebri ,Pubertad ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Introduction: Pseudotumor cerebri (PC) in prepubertal patients displays certain characteristics that differentiate it from its presentation at the postpubertal stage. The aim of this study is to describe the characteristics of paediatric patients diagnosed with PC at our centre and to compare them according to their pubertal status. Patients and methods: We included patients aged between 1 and 18 years who were diagnosed with PC in a tertiary-level hospital between 2006 and 2019 and who met the updated diagnostic criteria for PC. They were classified according to body weight and pubertal status. Subsequently, we analysed results from lumbar punctures, neuroimaging studies, ophthalmological assessments, and treatments received during follow-up. Results: We included 28 patients, of whom 22 were of prepubertal age and 6 were of postpubertal age. The mean age (standard deviation) was 9.04 (2.86) years. Among the postpubertal patients, 83.3% were boys, 66.7% of whom presented overweight/obesity. In the group of prepubertal patients, 27% were boys, 31.8% of whom were overweight. The most frequent symptoms were headache (89.9%) and blurred vision (42.9%). All patients presented papilloedema, and 21.4% manifested sixth nerve palsy. Possible triggers were identified in 28.6% of cases. Nineteen percent of patients presented clinical recurrence, all of whom were prepubertal patients. Complete clinical resolution was achieved in 55.6% of patients. Conclusion: Prepubertal patients with PC show lower prevalence of obesity, higher prevalence of secondary aetiologies, and higher recurrence rates than postpubertal patients. Resumen: Introducción: El Síndrome de Pseudotumor Cerebri (SPTC) en pacientes prepuberales presenta características que lo diferencian respecto a su presentación en la etapa postpuberal. Nuestro objetivo es describir las características de los pacientes diagnosticados de SPTC pediátrico en nuestro centro y compararlas en función de su estado puberal. Pacientes y métodos: Se incluyeron a los pacientes diagnosticados de SPTC en un hospital de tercer nivel entre los años 2006 y 2019 con edades comprendidas entre 1 y 18 años que cumplieran los criterios diagnósticos actualizados del SPTC. Se clasificaron en función de su estado puberal y peso corporal. Posteriormente, se analizaron los datos de las punciones lumbares, estudios de neuroimagen, valoraciones oftalmológicas, así como el régimen terapéutico recibido a lo largo de su seguimiento. Resultado: Se recogieron 28 pacientes, 22 prepuberales y 6 postpuberales, con edad media de 9,04 ± 2,86 años. El 83,3% de los pacientes postpuberales eran varones presentando sobrepeso/obesidad en el 66,7%. Eran varones el 27% de los pacientes prepuberales, de ellos asociaban sobrepeso el 31,8%. La sintomatología más frecuente fue cefalea (89,9%) y visión borrosa (42,9%). Todos los pacientes presentaron papiledema; un 21,4% de los casos presentaron parálisis del VI par. Se identificó un posible desencadenante en un 28,6%. El 19% presentaron recurrencia clínica, siendo todos ellos prepuberales. La resolución clínica completa se produjo en el 55,6% de los pacientes. Conclusión: Pacientes con SPTC presentan menor prevalencia de obesidad en la etapa prepuberal, junto con un mayor porcentaje de etiologías secundarias y tasa de recurrencia que los pacientes postpuberales.
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- 2024
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38. Síndrome de pseudotumor cerebri en la población pediátrica: características clínicas, tratamiento y pronóstico
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F. Labella ÿlvarez, J.A. Fernández-Ramos, R. Camino León, E. Ibarra de la Rosa, and E. López Laso
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Benign intracranial hypertension ,Child ,Idiopathic intracranial hypertension ,Obesity ,Pseudotumor cerebri ,Puberty ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Resumen: Introducción: El síndrome de pseudotumor cerebri (SPTC) en pacientes prepuberales presenta características que lo diferencian respecto a su presentación en la etapa pospuberal. Nuestro objetivo es describir las características de los pacientes diagnosticados de SPTC pediátrico en nuestro centro y compararlas en función de su estado puberal. Pacientes y métodos: Se incluyeron a los pacientes diagnosticados de SPTC en un hospital de tercer nivel entre los años 2006 y 2019 con edades comprendidas entre uno y 18 años que cumplieran los criterios diagnósticos actualizados del SPTC. Se clasificaron en función de su estado puberal y peso corporal. Posteriormente, se analizaron los datos de las punciones lumbares, estudios de neuroimagen, valoraciones oftalmológicas, así como el régimen terapéutico recibido a lo largo de su seguimiento. Resultados: Se recogieron 28 pacientes, 22 prepuberales y seis pospuberales, con edad media de 9,04 ± 2,86 años. El 83,3% de los pacientes pospuberales eran varones presentando sobrepeso/obesidad en el 66,7%. Eran varones el 27% de los pacientes prepuberales, de ellos asociaban sobrepeso el 31,8%. La sintomatología más frecuente fue cefalea (89,9%) y visión borrosa (42,9%). Todos los pacientes presentaron papiledema; un 21,4% de los casos presentaron parálisis del VI par. Se identificó un posible desencadenante en un 28,6%. El 19% presentaron recurrencia clínica, siendo todos ellos prepuberales. La resolución clínica completa se produjo en el 55,6% de los pacientes. Conclusión: Pacientes con SPTC presentan menor prevalencia de obesidad en la etapa prepuberal, junto con un mayor porcentaje de etiologías secundarias y tasa de recurrencia que los pacientes pospuberales. Abstract: Introduction: Pseudotumor cerebri (PC) in prepubertal patients displays certain characteristics that differentiate it from its presentation at the postpubertal stage. The aim of this study is to describe the characteristics of paediatric patients diagnosed with PC at our centre and to compare them according to their pubertal status. Patients and methods: We included patients aged between 1 and 18 years who were diagnosed with PC in a tertiary-level hospital between 2006 and 2019 and who met the updated diagnostic criteria for PC. They were classified according to body weight and pubertal status. Subsequently, we analysed results from lumbar punctures, neuroimaging studies, ophthalmological assessments, and treatments received during follow-up. Results: We included 28 patients, of whom 22 were of prepubertal age and 6 were of postpubertal age. The mean age (standard deviation) was 9.04 (2.86) years. Among the postpubertal patients, 83.3% were boys, 66.7% of whom presented overweight/obesity. In the group of prepubertal patients, 27% were boys, 31.8% of whom were overweight. The most frequent symptoms were headache (89.9%) and blurred vision (42.9%). All patients presented papilloedema, and 21.4% manifested sixth nerve palsy. Possible triggers were identified in 28.6% of cases. Nineteen percent of patients presented clinical recurrence, all of whom were prepubertal patients. Complete clinical resolution was achieved in 55.6% of patients. Conclusion: Prepubertal patients with PC show lower prevalence of obesity, higher prevalence of secondary aetiologies, and higher recurrence rates than postpubertal patients.
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- 2024
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39. Correlation between Diagnostic Magnetic Resonance Imaging Criteria and Cerebrospinal Fluid Pressure in Pediatric Idiopathic Intracranial Hypertension
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Behnam Beizaei, Farrokh Seilanian Toosi, Yousef Shahmoradi, Javad Akhondian, Farah Ashrafzadeh, Mehran Beiraghi Toosi, Shima Imannezhad, Alireza Kooshki, Ehsan Hassan Nejad, Asma Payandeh, Nahid Tavakkolizadeh, AmirAli Moodi Ghalibaf, and Narges Hashemi
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magnetic resonance imaging ,cerebrospinal fluid ,pseudotumor cerebri ,pediatrics ,Internal medicine ,RC31-1245 ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Purpose Idiopathic intracranial hypertension (IIH) is a clinical syndrome that mimics brain tumors with increased intracranial pressure. The present study is designed to investigate the diagnostic criteria of magnetic resonance imaging (MRI) and the severity of cerebrospinal fluid (CSF) pressure to understand the relationship and frequency of these criteria with the level of CSF pressure. Methods The present cross-sectional study was conducted on children diagnosed with IIH between the years 2011 and 2020, who were admitted to the pediatric neurology department of Ghaem Hospital, Mashhad, Iran. Clinical manifestations and imaging findings of the patients were recorded through a checklist. Results Forty-nine patients were included in the study; 27 (55.1%) were male, and 22 (44.9%) were female. The average CSF pressure was 40.64±20.63 cmH2O. The mean diameter distension of the perioptic subarachnoid space was 6.02±1.21 mm. Six (10.8%) patients had unilateral transverse sinus stenosis with an average CSF pressure of 20.47±36.80 cmH2O and 11 (21.4%) patients had bilateral transverse sinus stenosis with an average pressure of 48.22±21.04 cmH2O. In 22 (44.89%) patients, flattening of the posterior globe with the CSF pressure of 48.80±17.94 cmH2O was reported. Twenty-four (49%) patients had optic nerve tortuosity, with an average CSF pressure of 46.52±20.33 cmH2O. Among the diagnostic criteria, the pressure had a significant relationship with the flattening of the posterior globe (P
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- 2024
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40. Venous Sinus Stenting With the River Stent in IIH
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- 2023
41. Correlation between Diagnostic Magnetic Resonance Imaging Criteria and Cerebrospinal Fluid Pressure in Pediatric Idiopathic Intracranial Hypertension.
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Beizaei, Behnam, Toosi, Farrokh Seilanian, Shahmoradi, Yousef, Akhondian, Javad, Ashrafzadeh, Farah, Toosi, Mehran Beiraghi, Imannezhad, Shima, Kooshki, Alireza, Nejad, Ehsan Hassan, Payandeh, Asma, Tavakkolizadeh, Nahid, Ghalibaf, AmirAli Moodi, and Hashemi, Narges
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CEREBROSPINAL fluid pressure , *INTRACRANIAL hypertension , *MAGNETIC resonance imaging , *BRAIN tumors , *SUBARACHNOID space , *PEDIATRIC neurology - Abstract
Purpose: Idiopathic intracranial hypertension (IIH) is a clinical syndrome that mimics brain tumors with increased intracranial pressure. The present study is designed to investigate the diagnostic criteria of magnetic resonance imaging (MRI) and the severity of cerebrospinal fluid (CSF) pressure to understand the relationship and frequency of these criteria with the level of CSF pressure. Methods: The present cross-sectional study was conducted on children diagnosed with IIH between the years 2011 and 2020, who were admitted to the pediatric neurology department of Ghaem Hospital, Mashhad, Iran. Clinical manifestations and imaging findings of the patients were recorded through a checklist. Results: Forty-nine patients were included in the study; 27 (55.1%) were male, and 22 (44.9%) were female. The average CSF pressure was 40.64±20.63 cmH2O. The mean diameter distension of the perioptic subarachnoid space was 6.02±1.21 mm. Six (10.8%) patients had unilateral transverse sinus stenosis with an average CSF pressure of 20.47±36.80 cmH2O and 11 (21.4%) patients had bilateral transverse sinus stenosis with an average pressure of 48.22±21.04 cmH2O. In 22 (44.89%) patients, flattening of the posterior globe with the CSF pressure of 48.80±17.94 cmH2O was reported. Twenty-four (49%) patients had optic nerve tortuosity, with an average CSF pressure of 46.52±20.33 cmH2O. Among the diagnostic criteria, the pressure had a significant relationship with the flattening of the posterior globe (P<0.022). Conclusion: Since MRI is a non-invasive method for examining IIH, the findings of this study may aid in diagnosing and monitoring these patients. [ABSTRACT FROM AUTHOR]
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- 2024
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42. The manifestations of metabolic acidosis during acetazolamide treatment in a cohort of pediatric idiopathic intracranial hypertension.
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Bulkowstein, Yarden, Nitzan‑Luques, Adi, Schnapp, Aviad, Barnoy, Noa, Reif, Shimon, Gilboa, Tal, and Volovesky, Oded
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METABOLIC disorder diagnosis , *ACETAZOLAMIDE , *RESEARCH , *BLOOD gases analysis , *SCIENTIFIC observation , *RETROSPECTIVE studies , *METABOLIC disorders , *RISK assessment , *DESCRIPTIVE statistics , *METROPOLITAN areas , *ACIDOSIS , *INTRACRANIAL hypertension , *LONGITUDINAL method , *DISEASE risk factors , *CHILDREN - Abstract
Background: Idiopathic intracranial hypertension is characterized by increased intracranial pressure with unidentified pathology. Despite its use as the first-line treatment, data on acetazolamide's effectiveness and safety in pediatric idiopathic intracranial hypertension is sparse. This study's objective was to assess those issues and the need for routine blood gas monitoring during treatment. Methods: Retrospective observational cohort study, based on multicenter computerized medical charts of pediatric patients with idiopathic intracranial hypertension diagnosed between 2007–2018 in three medical centers serving one metropolitan area (an estimated population of 400,000 children). Clinical and laboratory data of children up to 18 years old, fulfilling the Friedman criteria and taking acetazolamide, were collected and analyzed. Results: Sixty-eight patients were included with a mean acetazolamide treatment duration of 8.5 months and a median maximal dose 18 mg/kg/d. Sixty-two children had mild (76%), moderate (13%), or severe (1.5%) metabolic acidosis. At least one adverse effect (neurologic, gastrointestinal, renal) was recorded among 27% of patients. No significant difference was found between the mean pH of children with or without clinical adverse effects (p = 0.35). No correlation was found between laboratory acidosis and adverse effect severity (p = 0.3), or between median acetazolamide dose and acidosis level (p = 0.57). Conclusions: Although laboratory finding of metabolic acidosis is common among patients with idiopathic intracranial hypertension treated with acetazolamide, it is not correlated with clinics. Therefore, we recommend sending blood tests during acetazolamide treatment based on clinical judgment. [ABSTRACT FROM AUTHOR]
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- 2024
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43. Effect of Inhaled Sevoflurane on Pediatric Cerebrospinal Fluid Pressure During Lumbar Puncture; Implications for Intracranial Hypertension.
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Aylward, Shawn C., Aylward, Brandon S., and Fedel, Gina M.
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FLUID pressure , *CEREBROSPINAL fluid , *INTRACRANIAL hypertension , *LUMBAR puncture , *SEVOFLURANE - Abstract
Objective: To determine influence of sevoflurane on changes in cerebrospinal fluid pressure in children presenting for lumbar puncture. Methods: Cerebrospinal fluid pressure, end tidal carbon dioxide, and end tidal sevoflurane concentration measurements were obtained at 2-minute intervals for a total of 10 minutes (T0 to T5). Because of concerns regarding patient safety and comfort, the study measurements were completed at the end of the lumbar procedure, starting with the closing pressure and when sevoflurane was stopped. Results: As end tidal sevoflurane concentration decreased, cerebrospinal fluid pressure initially increased up to T2 before decreasing back to around the initial point. There was no significant correlation between sevoflurane level and cerebrospinal fluid pressure. Both weight status and presence or absence of optic edema did not have a significant impact on pressure over time. However, there was a statistically significant difference in the cerebrospinal fluid pressure over time between those with spontaneous respirations compared to those without. Conclusions: There was no significant correlation between the end tidal sevoflurane concentration and cerebrospinal fluid pressure. Assisted ventilation did produce a statistically significant increase in cerebrospinal fluid pressure and suggests that the most accurate measurements are in those with spontaneous respirations. [ABSTRACT FROM AUTHOR]
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- 2024
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44. A systematic review on idiopathic intracranial hypertension comorbid with polycystic ovarian syndrome and its consequences.
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Rzewuska, Natalia, Kunicki, Jacek, Pieniak, Katarzyna, Laskus, Paulina, Zabielska, Bernadeta, Smolarczyk, Roman, and Kunicki, Michał
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INTRACRANIAL hypertension , *OBESITY in women , *ENDOCRINE diseases , *CHILDBEARING age , *SCIENTIFIC literature , *PREGNANCY complications - Abstract
• PCOS among patients with IIH was observed, with incidence rates ranging from 15.5% to 57%. • PCOS associated with obesity facilitates concurrence of IIH. • The factor connecting PCOS and IIH is obesity, weight loss is an important therapeutic aspect. • Women with coexisting IIH and PCOS have an increased risk of some pregnancy-related complications. A few publications have examined the frequency and medical implications of individuals with idiopathic intracranial hypertension (IIH) and polycystic ovarian syndrome (PCOS), but the findings have been inconclusive. IIH and PCOS both mainly affect obese women of reproductive age and have an impact on women's health at various levels. The aim of this systematic review was to compare the prevalence and association between comorbid IIH and PCOS, and their effect on such aspects as metabolism, abnormalities in hormone levels, and reproduction. The criterion for inclusion was a research study of patients suffering from both syndromes. We excluded review articles, case reports, and papers with an inappropriate study design, patient population or outcomes. Electronic databases PubMed, Scopus, Web of Science and gray literature were searched to retrieve studies published from inception to June 10, 2023. The risk of bias assessment was conducted utilizing Covidence software and by discussion between co-authors. After applying our inclusion/exclusion criteria, we consolidated the initial pool to a final selection of 9 articles, and 2185 patients with comorbidity of these two conditions. The prevalence of PCOS among patients with IIH was observed, with incidence rates ranging from 15.5% to 57%, which is up to 8 times greater, than the 4–10% prevalence of PCOS in the general population. These data may be valuable in clinical practice for both neurologists and gynecologists. PCOS associated with obesity facilitates concurrence of IIH. The diagnosis of concurrence of IIH and PCOS may have significant clinical implications for patients due to the accompanying hormonal disorders, obesity-related consequences, and fertility issues. Other No systematic review was found. We have registered the study in PROSPERO (International prospective register of systematic reviews), and the registration number is CRD42023437485. [ABSTRACT FROM AUTHOR]
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- 2024
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45. The Vienna idiopathic intracranial hypertension database—An Austrian registry.
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Pruckner, Philip, Mitsch, Christoph, Macher, Stefan, Krajnc, Nik, Marik, Wolfgang, Novak, Klaus, Wöber, Christian, Pemp, Berthold, and Bsteh, Gabriel
- Abstract
Summary: Background: Idiopathic intracranial hypertension (IIH) is becoming increasingly more prevalent bearing the risk of visual impairment and affecting the quality of life. Clinical presentation and outcome are heterogeneous. Large, well-characterized cohorts are scarce. Objective: To characterize the clinical spectrum, diagnostic findings, therapeutic management, and outcome of IIH. Methods: We identified patients with IIH according to modified Friedman criteria treated at our center between 2014 and 2021. The Vienna IIH database is described in detail. Results: Of 113 patients 89% were female (mean age 32.3 years). Median body mass index (BMI) was 31.8, with 85% overweight (BMI > 25) and 5% were classified as IIH without papilledema. Headache was present in 84% and showed migraine features in 43%. Median opening pressure in lumbar puncture was 31 cmH
2 O. Pharmacotherapy (predominantly acetazolamide) was established in 99%, 56% required at least 1 therapeutic lumbar puncture and 13% a surgical intervention. After a median 3.7 years follow-up, 57% had achieved significant weight loss, papilledema was present in 59% and headache in 76% (58% improved). Comparing initial presentation to follow-up, perimetry was abnormal in 67% vs. 50% (8% worsened, 24% improved) and transorbital sonography in 87% vs. 65% with a median optic nerve sheath diameter of 5.4 mm vs. 4.9 mm. Median peripapillary retinal nerve fiber layer thickness decreased from 199 µm to 99 µm and ganglion cell layer volume from 1.13 mm3 to 1.05 mm3 . Conclusion: The large representative Vienna IIH cohort characterizes IIH-related symptoms, diagnostic findings, treatment, and outcome emphasizing substantial long-term sequelae of IIH. Future analyses will aim to refine phenotyping and identify factors predicting outcome. [ABSTRACT FROM AUTHOR]- Published
- 2024
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46. Sensorimotor Radiculopathy Caused by Intracranial Hypertension Treated with CSF Diversion: Case Report.
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Şirinoğlu, Deniz, Başkurt, Ozan, Avcı, İdris, and Aydın, Mehmet Volkan
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PHYSICAL diagnosis ,PHYSICAL therapy ,LEG ,INTRACRANIAL hypertension ,RADICULOPATHY ,ROUTINE diagnostic tests ,VENOGRAPHY ,MUSCLE strength ,LUMBAR vertebrae ,MEDICAL drainage ,PAIN ,CEREBROSPINAL fluid shunts ,BACKACHE ,LUMBAR puncture ,PATIENT aftercare ,DISEASE complications ,SYMPTOMS - Abstract
Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
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47. Transvers sinus stenting for treatment of resistant tinnitus due to pseudotumor cerebri syndrome without papilloedema
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Rezafarhad Manteghifasaei, Mohammadali Arami, and Mohammad Karimi
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Pseudotumor cerebri ,Tinnitus ,Transvers sinus stenting ,Intracranial pressure (ICP) ,Surgery ,RD1-811 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Introduction: Pseudotumor cerebri is one of the complex diseases in the field of neurology and neurosurgery. Although it’s classical form manifests with headache and blurred vision, and papilledema is seen in the ophthalmological examination, but its clinical manifestations can be without blurred vision and papilledema, and even without headache.Here, we present a diagnostically challenging pseudotumor cerebri case who presented only with refractory tinnitus and had increased intracranial pressure, and the tinnitus was completely resolved with transverse sinus stenting. Conclusion: This case showed that pseudotumor cerebri can have atypical manifestations such as resistant tinnitus without papilledema, and in these cases, intracranial pressure should be measured and its causes, especially cerebral venous sinus stenosis should be investigated and treated.
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- 2024
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48. Pseudotumor cerebri with status epilepticus in a child: A rare presentation of vitamin D deficiency
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Soumya Pahari, Prakash Kunwar, Subi Acharya, Pallavi Rauniyar, and C. K. Sagar Bahadur
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case report ,elevated intracranial pressure ,pseudotumor cerebri ,status epilepticus ,vitamin D deficiency ,Medicine ,Medicine (General) ,R5-920 - Abstract
Key Clinical Message Pseudotumor cerebri (PTC) encompasses a constellation of symptoms caused by elevated intracranial pressure of unclear etiology. Various associations have been described, rarely hypovitaminosis D. Vitamin D deficiency should be considered as a potential etiology of neurological manifestations like PTC and seizures in children. Early diagnosis and correction of vitamin D deficiency is key to preventing morbidity and achieving good outcomes.
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- 2024
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49. Case report: Association between PTEN-gene variant and an aggressive case of multiple dAVFs
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Glaucia Suzanna Jong-A-Liem, Talita Helena Martins Sarti, Mariusi Glasenapp dos Santos, Luciano Marcus Tirotti Giacon, Raphael Wuo-Silva, Alex Machado Baeta, José Maria de Campos Filho, and Feres Chaddad-Neto
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pseudotumor cerebri ,gene variant ,AV fistulas ,dural arteriovenous fistula (DAVF) ,PTEN gene mutation ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
IntroductionMutations of the phosphatase and tensin homolog (PTEN) gene have been associated with a spectrum of disorders called PTEN hamartoma tumor syndrome, which predisposes the individual to develop various types of tumors and vascular anomalies. Its phenotypic spectrum includes Cowden syndrome (CS), Bannayan–Riley–Ruvalcaba syndrome (BRRS), Proteus syndrome, autism spectrum disorders (ASD), some sporadic cancers, Lhermitte–Duclos disease (LDD), and various types of associated vascular anomalies.Clinical presentationA previously healthy 27-year-old woman was experiencing visual scintillating scotomas and mild chronic headaches for the past 2 years. The initial computed tomographic (CT) and magnetic resonance imaging (MRI) scans did not reveal any abnormalities, but the possibility of pseudotumor cerebri was considered. Furthermore, a cerebral angiogram showed a posterior fossa dural arteriovenous fistula (dAVF), which was initially treated through embolization. However, in spite of proper treatment, this patient experienced multiple recurrent dAVFs in different locations, requiring multiple embolizations and surgeries. Despite exhibiting altered cerebral perfusion and hemodynamics, the patient did not display any significant symptoms until she experienced a sudden stroke resulting from deep venous thrombosis, which was not associated with any medical procedures or medication use. A comprehensive analysis was performed due to the aggressive nature of the dAVFs. Surprisingly, exome sequencing of a blood sample revealed a PTEN gene variant in chromosome 10, indicative of Cowden syndrome. However, no tumors or other vascular lesions were detected in other systems that would constitute Cowden syndrome.ConclusionThe rapid formation of multiple and complex dAVFs, coupled with not meeting the criteria for any other PTEN-related syndrome, unequivocally leads to the presentation of a novel phenotype of the PTEN germline variant.
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- 2024
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50. Assessment of Venous Drainage in Idiopathic Intracranial Hypertension (HYPERPIC)
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- 2023
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