Pediatric intracranial hypertension. Experience from 2 Tertiary Centers

Neurosciences (Riyadh). 2019 Oct;24(4):257-263. doi: 10.17712/nsj.2019.4.20190052.

Abstract

Objective: To review the experience of 2 tertiary centers in Saudi Arabia with intracranial hypertension (IH) in the pediatric population.

Methods: We retrospectively reviewed and analyzed pediatric patients diagnosed with IH from June 2002 to May 2017 in 2 institutes.

Results: We identified 53 patients (30 females and 23 males) with a mean age of 7 years at the time of presentation. Among them, 41 patients were younger than 12 years, and 12 were older. Obese and overweight patients constituted 27.00% (n = 14) of all cases, 8 (66.7%) of whom were older than 12 years. The most common presenting feature was papilledema followed by headache. Vitamin D deficiency, which constituted the most common associated condition, was identified in 12 (22.6%) patients. Acetazolamide was the treatment option in 98.11% of patients, and only 5.7% underwent surgical interventions. The length of follow-up ranged from 6 months to 8 years.

Conclusion: Intracranial hypertension is rare in children and commonly seen in overweight females older than 12 years similar to adults. Patients younger than 12 years tend to develop secondary IH. More studies are needed to characterize the clinical presentation and guide the management plan.

MeSH terms

  • Acetazolamide / therapeutic use
  • Child
  • Child, Preschool
  • Diuretics / therapeutic use
  • Female
  • Headache / epidemiology*
  • Hospitals, Pediatric / statistics & numerical data
  • Humans
  • Infant
  • Intracranial Hypertension / complications*
  • Intracranial Hypertension / drug therapy
  • Intracranial Hypertension / epidemiology
  • Intracranial Hypertension / pathology
  • Male
  • Obesity / epidemiology*
  • Papilledema / epidemiology*
  • Saudi Arabia
  • Tertiary Care Centers / statistics & numerical data
  • Vitamin D Deficiency / epidemiology*

Substances

  • Diuretics
  • Acetazolamide