Pediatric Idiopathic Intracranial Hypertension: A not so Rare and Benign Condition

JOURNAL TITLE: Clinical Rhinology

Author
1. Karan Gupta
2. Manish Modi
ISSN
0974-4630
DOI
10.5005/jp-journals-10013-1180
Volume
7
Issue
1
Publishing Year
2014
Pages
5
Author Affiliations
    1. Postgraduate, Institute of Medical Education and Research, Chandigarh, India
    2. Postgraduate Institute of Medical Education and Research, Chandigarh
    3. Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India
    4. Postgraduate Institute of Medical Education and Research, Chandigarh, India
    5. Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
    6. Postgraduate Institute of Medical, Education and Research, Chandigarh, India
    7. Postgraduate Institute of Medical, Education and Research (PGIMER), Chandigarh, India
    1. Department of Otolaryngology and Head and Neck Surgery Postgraduate Institute of Medical Education and Research, Chandigarh India
  • Article keywords
    Pediatric, Idiopathic intracranial hypertension, Optic nerve fenestration

    Abstract

    Objective

    Pediatric idiopathic intracranial hypertension is an underdiagnosed entity with catastrophic presentations. High index of suspicion with early diagnosis and prompt treatment is the key to successful management. Trans-nasal trans-sphenoid Endoscopic Optic Nerve Fenestration is an effective surgical modality for the reversal of vision loss in pediatric idiopathic intracranial hypertension (IIH).

    Materials and methods

    This is a single center observational prospective case series. Five diagnosed pediatric patients of IIH satisfying the modified Dandy criteria and reported to the out-patient services of otolaryngology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India in the year 2012 were included in this study. All children underwent thorough clinical examination, complete Neuro-ophthalmological work-up including Visual acuity (V/A), Visual field charting (V/F), Fundus venogram and Radiological work-up with MRI for special optic nerve sections in sagittal reconstruction. Cerebro-Spinal Fluid pressure (CSF) measured preoperatively for all children. Standard endoscopic optic nerve Sheath Fenestration was performed on all children. visual improvement was assessed by comparing preoperative ophthalmological findings.

    Results

    Improvement in vision was taken as a positive outcome. Vision improved in all except one child, who had pre-existing optic nerve atrophy.

    Conclusion

    Endoscopic optic nerve fenestration is an effective minimally invasive procedure to revert visual loss in pediatric idiopathic intracranial hypertension.

    How to cite this article

    Gupta AK, Gupta K, Modi M, Gupta A. Pediatric Idiopathic Intracranial Hypertension: A not so Rare and Benign Condition. Clin Rhinol An Int J 2014;7(1):5-9.

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