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Pediatric Idiopathic Intracranial Hypertension

Background

Idiopathic intracranial hypertension (IIH; also known as pseudotumor cerebri [PTC] or benign intracranial hypertension [BIH]) is characterized by signs and symptoms of increased intracranial pressure (ICP) in the absence of a space-occupying lesion.

IIH mainly occurs among obese women of childbearing age.
Although its prevalence among the pediatric population is not known, it is not uncommon among the young. In children younger than 6 years, a specific cause of intracranial hypertension can usually be identified. Primary or idiopathic cases of intracranial hypertension are usually seen after age 11 years.

Prepubertal children with PTC have a lower incidence of obesity compared with adults, and there is no sex predilection. Similar to adult patients, children are at risk for the development of permanent visual loss.

Children with IIH usually complain of headaches and may have vomiting, blurred vision, and horizontal diplopia. The headaches are diffuse, worse at night, and often aggravated by sudden movement. Less common complaints include irritability, transitory visual obscurations, dizziness, and tinnitus.

As in adults, treatment is designed to reduce ICP and preserve vision. (See Idiopathic Intracranial Hypertension.)

Although IIH has been recognized for over a century, the need remains for prospectively collected data to promote a better understanding of the etiology, risk factors, evaluative methods, and effective treatments for children with this syndrome.

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