Pediatric Pseudotumor Cerebri: Single-Center Experience from Diagnosis to Treatment

INTRODUCTION: Pseudotumor cerebri(PTC) is characterized by increased intracranial pressure without the presence of any intracranial mass. PTC presents with symptoms such as headache, nausea, vomiting, and visual disturbances. The aim of this study is to retrospectively evaluate the clinical, laboratory, demographic, and radiological findings of pediatric patients followed with a diagnosis of PTC in our clinic.
METHODS: Cases diagnosed with PTC between the years 2015-2022 and followed for at least 6 months were included in the study. The patients' clinical features, laboratory results, cerebrospinal fluid(CSF) pressure measurements, brain magnetic resonance imaging(MRI) findings and ophthalmologic examination results were retrospectively evaluated.
RESULTS: The study population consist of 27(63%) female and 16(37%) male. The mean follow-up duration was 11.3±6.6(6-30) months. The symptoms of the cases included headache in 32(74%), nausea-vomiting in 14(32%), diplopia in 11(25%), cranial nerve involvement in 9 (20%), blurred vision in 8(19%), and photophobia in 7(16%). Papilledema was present in 37(86%) of the cases, with a mean CSF pressure of 36.1±10.3(26-67)cm H2O.When comparing the retinal nerve fiber layer(RNFL) thickness of the right and left eyes in 27 cases during diagnosis and follow-up, it was observed that RNFL values that were higher during diagnosis had significantly decreased during follow-up (respectively, p=0.001, p=0.001). The most commonly recommended treatment was acetazolamide.

DISCUSSION AND CONCLUSION: PTC is a disease that is relatively common in children, although not as much as in adults. To prevent the development of optic atrophy that can lead to visual impairment, cases should be promptly diagnosed, treated and interdisciplinary follow-up is required.

Keywords: pseudotumor cerebri, papilledema, headache, pediatric patients