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Abstract
RÉSUMÉ
L’hypertension intra crânienne idiopathique ou pseudo tumor cerebri est une pathologie rare chez l’enfant. Quand le diagnostic est tardif, la prise en charge des lésions avancées conséquentes grève en règle le pronostic visuel. Nous rapportons le cas d’une enfant de six ans référée pour une baisse d’acuité visuelle bilatérale associée à des céphalées et des vomissements. L’examen ophtalmologique a noté une acuité visuelle réduite à la perception lumineuse à l’œil droit et à 1/20e à l’œil gauche. Une paralysie du VI droit et un œdème papillaire bilatéral étaient également présents. Aucun processus expansif ou tumeur n’a été mis en évidence aux explorations radiologiques. L’analyse du liquide céphalorachidien et les analyses biologiques étaient sans particularités. L’enfant a été mise sous corticoïdes et inhibiteurs de l’anhydrase carbonique sans amélioration.
ABSTRACT
Intracranial hypertension or pseudo-tumor cerebri is a rare disease in children. The late diagnosis will delay the management and worsen the visual prognosis. We report the case of a 6-year-old girl referred for decreased bilateral visual acuity associated with headache and vomiting. Ophthalmologic examination noted reduced visual acuity to light perception at the right eye and 1/20th at the left eye. Paralysis of the right VI and bilateral papilloedema were also found. Medical imaging disclosed no expansive process or tumor. Analysis of cerebrospinal fluid and bleed showed no significant abnormalities. Treatment included corticosteroids and inhibitors of carbonic anhydrase, but there was no visual improvement.
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References
- Wall M, George D. Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain 1991;114:55-80.
- Gordon K. Pediatric pseudotumor cerebri: descriptive epidemiology. Can J Neurol Sci. 1997;124: 253-5.
- Karahalios DG, Rekate HL, Khayata MH, ApostodiesPJ. Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology. 1996; 46: 198-202.
- Balcer U, Liu G T, Forman S, Pun K, Volpe NJ, Galetta S L, Maguire Mg. Idiopathic intracranial hypertension: relation of age and obesity in children. Neurology. 1999; 52: 870-2.
- Lessell S. Pediatric pseudotumor cerebri (idiopathic intracranial hypertension). Surv Ophthalmol 1992;37:155-66.
- CinciripiniGS, Donahue S, Borchert MS. Idiopathic intracranial hypertension in prepubertal pediatric patients: characteristics, treatment and outcome. Am J Ophthalmol. 1999;127:178-82.
- Said RR, Rosman NP: A negative cranial computed tomographic scan is not adequate to support a diagnosis of pseudotumor cerebri. J Child Neurol 2004;19:609–613.
- Avery RA, Shah SS, Licht DJ, et al. Reference range for cerebrospinal fluid opening pressure in children undergoing diagnostic lumbar puncture. N Engl J Med. 2010; 363:891-893.
- Lee MW, Vedanarayanan VV. Cerebrospinal fluid opening pressure in children: experience in a controlled setting. Pediatr Neurol. 2011; 45(4):238-240.
- Avery RA, Licht DJ, Shah SS, et al. CSF opening pressure in children with optic nerve head edema. Neurology. 2011; 76(19):1658-1661.
- Kaiser AM, Whitelaw AG. Normal cerebrospinal fluid pressure in the newborn. Neuropediatrics. 1986; 17:100-102.
- Babikian P, Corbett J, Bell W. Idiopathic intracranial hypertension in children: the lowa experience. J Child Neurol 1994; 9:144-9.
- Mauriello JA, Jr, Shaderowfsky P, Gizzi M, Frohman L: Management of visual loss after optic nerve sheath decompression in patients with pseudotumor cerebri. Ophthalmology 1995;102:441–445.
- Rekate HL, Wallace D: Lumboperitoneal shunts in children. PediatrNeurosurg 2003;38:41–46
- Phillips PH, Repka MX, Lambert SR: Pseudotumor cerebri in children. J AAPOS 1998;2:33–38.
- Kesler A, Fattal-Valevski A: Idiopathic intracranial hypertension in the pediatric population. J Child Neurol 2002;17:745–748.
- Youroukos S, Psychou F, Fryssiras S, Paikos P, Nicolaidou P: Idiopathic intracranial hypertension in children. J Child Neurol 2000;15:453–457.
- Stiebel-Kalish H, Kalish Y, Lusky M, Gaton DD, Ehrlich R, Shuper A: Puberty as a risk factor for less favorable visual outcome in idiopathic intracranial hypertension. Am J Ophthalmol 2006;142:279–283.
References
Wall M, George D. Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain 1991;114:55-80.
Gordon K. Pediatric pseudotumor cerebri: descriptive epidemiology. Can J Neurol Sci. 1997;124: 253-5.
Karahalios DG, Rekate HL, Khayata MH, ApostodiesPJ. Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology. 1996; 46: 198-202.
Balcer U, Liu G T, Forman S, Pun K, Volpe NJ, Galetta S L, Maguire Mg. Idiopathic intracranial hypertension: relation of age and obesity in children. Neurology. 1999; 52: 870-2.
Lessell S. Pediatric pseudotumor cerebri (idiopathic intracranial hypertension). Surv Ophthalmol 1992;37:155-66.
CinciripiniGS, Donahue S, Borchert MS. Idiopathic intracranial hypertension in prepubertal pediatric patients: characteristics, treatment and outcome. Am J Ophthalmol. 1999;127:178-82.
Said RR, Rosman NP: A negative cranial computed tomographic scan is not adequate to support a diagnosis of pseudotumor cerebri. J Child Neurol 2004;19:609–613.
Avery RA, Shah SS, Licht DJ, et al. Reference range for cerebrospinal fluid opening pressure in children undergoing diagnostic lumbar puncture. N Engl J Med. 2010; 363:891-893.
Lee MW, Vedanarayanan VV. Cerebrospinal fluid opening pressure in children: experience in a controlled setting. Pediatr Neurol. 2011; 45(4):238-240.
Avery RA, Licht DJ, Shah SS, et al. CSF opening pressure in children with optic nerve head edema. Neurology. 2011; 76(19):1658-1661.
Kaiser AM, Whitelaw AG. Normal cerebrospinal fluid pressure in the newborn. Neuropediatrics. 1986; 17:100-102.
Babikian P, Corbett J, Bell W. Idiopathic intracranial hypertension in children: the lowa experience. J Child Neurol 1994; 9:144-9.
Mauriello JA, Jr, Shaderowfsky P, Gizzi M, Frohman L: Management of visual loss after optic nerve sheath decompression in patients with pseudotumor cerebri. Ophthalmology 1995;102:441–445.
Rekate HL, Wallace D: Lumboperitoneal shunts in children. PediatrNeurosurg 2003;38:41–46
Phillips PH, Repka MX, Lambert SR: Pseudotumor cerebri in children. J AAPOS 1998;2:33–38.
Kesler A, Fattal-Valevski A: Idiopathic intracranial hypertension in the pediatric population. J Child Neurol 2002;17:745–748.
Youroukos S, Psychou F, Fryssiras S, Paikos P, Nicolaidou P: Idiopathic intracranial hypertension in children. J Child Neurol 2000;15:453–457.
Stiebel-Kalish H, Kalish Y, Lusky M, Gaton DD, Ehrlich R, Shuper A: Puberty as a risk factor for less favorable visual outcome in idiopathic intracranial hypertension. Am J Ophthalmol 2006;142:279–283.