Çocuklarda psödotümör serebri: etyoloji, klinik bulgular, prognoz

Amaç: Psödotümör serebri tanısı alan hastaların klinik ve nörogörüntüleme bulguları, etiyolojileri, tedavi şekilleri ve süreleri, tedaviye yanıtları ve nörolojik sekel varlıkları gözden geçirildiGereç ve Yöntem: Çalışmaya dahil edilen hastalar Haziran 2015 ile Mayıs 2018 arasında Çukurova Tıp Fakültesi Çocuk Nöroloji Bilim Dalında takip edildi. Yirmi yedi hastanın yaş, cinsiyet dağılımı, antropometrik ölçümleri, BOS basınçları, nörolojik, oftalmolojik, nörogörüntüleme, nörolojik sekel bulguları, tedavi modaliteleri ve süreleri, tedavi yanıtı retrospektif olarak incelendi. Bulgular:  BOS basıncı ortalaması 43,29,1cmH2O idi. Etiyolojide en sık neden obezite (%33,3), demir eksikliği anemisi (%18,5) ve venöz sinüs trombozu (%14,8) idi. Hastaların %59,3’üne yalnızca asetazolamid tedavisi verildi, %25,9’una topiramat eklendi, %14,8’ine steroid verildi. 25 hastanın nörolojik ve oftalmolojik bulgularında medikal tedavi ile tamamen düzelme görüldü.Sonuç: Psödotümör serebri hastalığında en sık oluşan nörolojik sekel kalıcı görme kaybıdır. Bu durum geri dönüşümsüz olur ve çocuğun tüm hayatını etkiler. Bu nedenle başağrısı, görme kaybı, çift görme şikayetleri olan çocuklarda Psödotümör serebri tanısının düşünülmesi gerektiğinin bilinmesi ve çocukların hızlı ve uygun şekilde tedavisi prognozda oldukça önemlidir.
Anahtar Kelimeler:

Psödotümor serebri, papil ödem

Pseudotumor cerebri in children: etiology, clinical findings, prognosis

Purpose: Clinical and neuroimaging findings, aetiologies, treatment modalities and durations, response to treatment, and neurological sequelae of the patients diagnosed with pseudotumor cerebri were reviewed.Materials and Methods: A total of 27 patients who followed up in the Department of Pediatric Neurology at Çukurova Medical Faculty between June 2015 and May 2018 were included in this study. Age, gender distribution, anthropometric measurements, cerebrospinal fluid pressures, neurological, ophthalmologic, neuroimaging and neurological sequelae findings, treatment modalities and durations, response to therapy of 27 patients were reviewed retrospectively. Results: Mean cerebrospinal fluid pressure was 43.29.1cmH2O. The most frequent cause in aetiology were obesity (33.3%), iron deficiency anemia (18.5%) and venous sinus thrombosis (14.8%). All patients were treated with acetazolamid, 59.3% patients received only acetazolamid and 25.9% of patients received combined therapy with acetazolamide and topiramate and 14.8% of patients received combined therapy with acetazolamide and steroids. Of the patients, 25 had excellent neurological and ophtalmological outcome with medical treatment. Conclusion: The most frequently-seen neurological sequelae in pseudotumor cerebri is permanent visual impairment This irreversible situation affects the whole life of child. Therefore it is quite important to think about the diagnosis of pseudotumor cerebri for the children with complaints of headache, visual impairment and diplopia, and to subject them to treatment quickly and properly.

Kaynakça

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