scholarly journals Optic fenestration in benign intracranial hypertension: case report

2020 ◽  
Vol 6 (12) ◽  
pp. 2289
Author(s):  
Manish Munjal ◽  
Monika Singla ◽  
Sahil Goel ◽  
Porshia Rishi ◽  
Nitika Tuli ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Intracranial Hypertension ◽  
Pseudotumor Cerebri ◽  
Fluid Composition ◽  
Benign Intracranial Hypertension ◽  
Raised Intracranial Pressure ◽  
Visual Effects ◽  
Emergency Intervention ◽  
Diamond Burr

<p class="abstract"><span lang="EN-US">Condition of raised intracranial pressure without any mass lesion and normal cerebrospinal fluid composition is termed as idiopathic intracranial hypertension or pseudotumor cerebri. Raised intracranial tension with visual effects was treated by trans-sphenoidal optic fenestration as an emergency intervention to salvage the vision. The lamina papyracea on either side was lifted off the orbital periosteum and thick bone of the ethmoid sphenoidal junction was drilled with a diamond burr to thin it and elevate the bone covering the optic nerve.</span></p>

scholarly journals Benign Intracranial Hypertension Due to Hypoparathyroidism: A Case Report

2022 ◽  
Vol 12 ◽  
Author(s):  
Giorgia Sforza ◽  
Annalisa Deodati ◽  
Romina Moavero ◽  
Laura Papetti ◽  
Ilaria Frattale ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Intracranial Hypertension ◽  
Lumbar Puncture ◽  
Idiopathic Intracranial Hypertension ◽  
Clinical Manifestations ◽  
Nausea And Vomiting ◽  
Benign Intracranial Hypertension ◽  
Blood Tests ◽  
Organ Systems

Objective: The objective of this study is to present the rare case of a young girl with idiopathic intracranial hypertension secondary to hypoparathyroidism.Background: Idiopathic intracranial hypertension is a neurological syndrome characterized by elevated intracranial pressure (&gt; 25 cmH2O) in the absence of intracerebral abnormalities or hydrocephalus. The pathophysiology of idiopathic intracranial hypertension is unknown, and rare cases of idiopathic intracranial hypertension secondary to hypoparathyroidism have been described. It is supposed that hypocalcemia causes decrease in the absorption of cerebrospinal fluid in arachnoidal granulations.Methods: The workup of the girl with idiopathic intracranial hypertension and hypoparathyroidism included physical examination, blood tests, diagnostic imaging, and lumbar puncture.Results: We present a 9-year-old female patient who was hospitalized for headache associated with nausea and vomiting for 3 weeks. She underwent an ophthalmologic examination that revealed papilledema. Lumbar puncture revealed an opening pressure of 65 cm H2O; cerebrospinal fluid analysis and brain computed tomography scan were normal. The patient started taking acetazolamide. Blood tests revealed hypocalcemia associated with high phosphorus level and undetectable PTH hormone, which led us to suspect hypoparathyroidism. She had never had cramps, paraesthesias, or tetany. Chvostek's and Trousseau's signs were positive. In the neck ultrasonography, parathyroids were not visible. Oral supplementation with calcitriol and calcium was started. Headache, nausea, and vomiting immediately disappeared after the lumbar puncture, and the papilledema improved gradually.Conclusions: Several anecdotal cases of idiopathic intracranial hypertension secondary to hypoparathyroidism have been described. However, our case report is of particular interest, since the child did not present with typical neurological hypoparathyroidism symptoms. Therefore, we recommend that hypoparathyroidism should be included in diagnostic investigations on children with clinical findings of idiopathic intracranial hypertension, because clinical manifestations of hypoparathyroidism are variable and may involve almost all organ systems.

BENIGN INTRACRANIAL HYPERTENSION AND OTITIC HYDROCEPHALUS

PEDIATRICS ◽  
1959 ◽  
Vol 23 (2) ◽  
pp. 257-259
Author(s):  
J. GORDON MILLICHAP
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypertension ◽  
Pseudotumor Cerebri ◽  
Common Symptom ◽  
Moderate Degree ◽  
Benign Intracranial Hypertension ◽  
Abducens Palsy ◽  
Increased Intracranial Pressure ◽  
Normal Composition ◽  
Infants And Young Children

BENIGN intracranial hypertension or pseudotumor cerebri, as the condition is termed more frequently, is a syndrome of increased intracranial pressure with a normal ventricular system and cerebrospinal fluid of normal composition. Headache of moderate degree is the most common symptom and vomiting, impairment of vision and diplopia occur less often; papilledema and abducens palsy are the usual neurologic signs. The prognosis is almost invariably good. Although few reports of the syndrome are found in pediatric literature, its occurrence is relatively common during childhood. The review of reports by Davidoff, Foley, and others has disclosed that 84 (37%) of 224 patients were children and of these 75 (90%) were between 5 and 15 years of age. The infrequent occurrence or recognition of the syndrome in infants and young children is noteworthy.

Benign intracranial hypertension associated with inhaled corticosteroids in a child with asthma

2021 ◽  
Vol 14 (5) ◽  
pp. e242455
Author(s):  
James Trayer ◽  
Declan O'Rourke ◽  
Lorraine Cassidy ◽  
Basil Elnazir
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypertension ◽  
Inhaled Corticosteroids ◽  
Benign Intracranial Hypertension ◽  
Inhaled Corticosteroid ◽  
Moderate Dose ◽  
Opening Pressure ◽  
Blurred Vision ◽  
Corticosteroid Dose ◽  
Steroid Side Effects

A 13-year-old male asthmatic presented to the general paediatric clinic with papilloedema identified following a check-up with his optician due to blurred vision. His asthma was well controlled on a moderate dose of inhaled corticosteroid and there had been no recent increase or decrease in the dose. A diagnosis of benign intracranial hypertension (BIH) was made based on a raised cerebrospinal fluid opening pressure, papilloedema, a normal neurological examination and normal neuroimaging. The only associated risk factor was his inhaled corticosteroids. He was commenced on acetazolamide and the inhaled corticosteroid dose was reduced, resulting in resolution of his papilloedema. This case serves to highlight that steroid side effects including BIH may occur at moderate doses of inhaled corticosteroids and that inhaled corticosteroid dose should be regularly reviewed and decreased to the lowest dose that maintains asthma control.

Significance of Empty Sella in Cerebrospinal Fluid Leaks

2003 ◽  
Vol 128 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Rodney J. Schlosser ◽  
William E. Bolger
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypertension ◽  
Sella Turcica ◽  
Radiographic Finding ◽  
Empty Sella ◽  
Senior Author ◽  
Csf Leak ◽  
Benign Intracranial Hypertension ◽  
Cerebrospinal Fluid Leaks ◽  
Csf Leaks

OBJECTIVE: The role of elevated cerebrospinal fluid (CSF) pressures in the pathophysiology of various CSF leaks is not clear. Empty sella syndrome (ESS) is a radiographic finding that can be associated with elevated CSF pressures and may represent a radiographic indicator of intracranial hypertension. We present our experience with CSF leaks of various causes, the prevalence of ESS in the spontaneous and nonspontaneous categories, and the potential pathophysiology and unique management issues of the spontaneous CSF leak group. METHODS: We conducted a retrospective review of medical records, imaging studies, and surgical treatment of CSF leaks in patients treated by the senior author. RESULTS: Sixteen patients with spontaneous CSF leaks and 12 patients with nonspontaneous CSF leaks were surgically treated from 1996 through 2002. In the spontaneous group, 15 patients had complete imaging of the sella turcica. Ten had completely empty sellae and 5 had partially empty sellae, for a total of 100% (15 of 15). In the nonspontaneous group, 9 patients had complete imaging of the sella. Only 11% (1 of 9) had a partially empty sella and that was a congenital leak. Comparison of proportions between these 2 groups was significant ( P = 0.01). The spontaneous group consisted primarily of obese, middle-aged females (13 of 16 patients). CONCLUSION: Empty sella probably represents a sign of elevated intracranial pressure that leads to idiopathic, spontaneous CSF leaks. Spontaneous CSF leaks are strongly associated with the radiographic finding of an empty sella and are more common in obese females, similar to benign intracranial hypertension. This unique population may require more aggressive surgical and medical treatment to prevent recurrent or multiple leaks.

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