Gonca BEKTAŞ, Edibe PEMBEGÜL YILDIZ, Tuğçe AKSU UZUNHAN, Nur AYDINLI, Mine ÇALIŞKAN, Meral ÖZMEN

ÇOCUKLUK ÇAĞINDA PRİMER VE SEKONDER PSÖDOTÜMÖR SEREBRİ SENDROMU-BAŞVURU SEMPTOMLARI VE BEYİN GÖRÜNTÜLEME BULGULARI

Objective: We aimed to define the demographic characteristics, referral symptoms, and neuroimaging findings in children with pseudotumor cerebri syndrome (PTCS) by comparing the differences between idiopathic intracranial hypertension (IIH) (primary PTSS) and secondary PTCS.Materials and Methods: We retrospectively evaluated the medical records and brain imaging findings of children with PTCS who were <18 years of age and were followed by the outpatient clinics of the Department of Child Neurology between January 2011 and January 2016. The children were categorized into two groups: (1) children with IIH and (2) children with secondary PTCS.Results: In total, 26 children were enrolled in the study; group 1 comprised 16 patients, and group 2 comprised 10 patients. In group 2, there were four patients with sinus venous thrombosis, one with autoimmune thyroiditis, one with hypothyroidism, one with Down syndrome, one with pituitary adenomas, and one with pregnancy related PTSS. One patient developed PTSS while receiving growth hormone therapy. At the time of admission, there was no statistically significant difference between the two groups in terms of age, prepubertal/postpubertal patient ratio, headache, double vision, visual disturbance/loss and presence of nausea/vomiting (p > 0.05). Positive radiological findings were not statistically different between the two groups (p > 0.05). Conclusion: In children with PTSS, the symptoms at onset and brain imaging findings were found to be similar between primary and secondary PTSS.

Anahtar Kelimeler:

Çocuk, psödotümör serebri, idyopatik intrakranial hipertansiyon

PRIMARY AND SECONDARY PSEUDOTUMOR CEREBRI SYNDROME IN CHILDHOOD: SYMPTOMS AND IMAGING FINDINGS

Amaç: Psödotümör serebri sendromu (PTSS) tanılı çocukların demografik özellikleri, başvuru semptomları ve görüntüleme bulgularını tanımlayarak idyopatik intrakranial hipertansiyon (İİH) (primer PTSS) ile sekonder PTSS arasındaki farkların saptanması amaçlandı. Gereç ve Yöntem: Ocak 2011 ile Ocak 2016 tarihleri arasında çocuk nörolojisi polikliniğinden PTSS tanısı ile takip edilmekte olan 18 yaşından küçük çocukların medikal kayıtları ve beyin görüntüleme bulguları geriye dönük olarak değerlendirildi. Çocuklar İİH tanılı olanlar ve sekonder PTSS gelişenler olmak üzere iki grupta incelendi.Bulgular: Çalışmaya 26 çocuk dahil edildi. Birinci grup 16, 2. grup 10 hastadan oluşuyordu. İkinci gruptaki hastaların 4’ünde sinüs ven trombozu, 1’inde otoimmün tiroidit, 1’inde hipotiroidi, 1’inde Down sendromu, 1’inde hipofiz adenomu, 1’inde gebelik ilişkili PTSS saptandı. Bir hastada ise büyüme hormonu tedavisi almakta iken PTSS gelişmişti. Başvuru anındaki yaş ortalamaları, prepubertal/postpubertal hasta oranı, baş ağrısı, çift görme, görme bulanıklığı/kaybı ve bulantı/kusma varlığı açısından gruplar arasında istatiksel açıdan anlamlı fark saptanmadı (p>0,05). Pozitif radyolojik bulgu oranı iki grup arasında istatiksel olarak farklı değildi (p>0,05). Sonuç: PTSS saptanan çocuklarda başvuru şikayetleri ve beyin görüntüleme bulguları idyopatik olanlar ile sekonder PTSS gelişenler arasında benzer bulunmuştur.

Keywords:

Child, pseudotumor cerebri, idiopathic intracranial hypertension,

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1. Standridge SM. Idiopathic intracranial hypertension in children: a review and algorithm. Pediatr Neurol 2010;43(6):377-90.
2. Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 2013;81(13):1159-65.
3. Markey KA, Mollan SP, Jensen RH, Sinclair AJ. Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions. Lancet Neurol 2016;15(1):78-91.
4. Paley GL, Sheldon CA, Burrows EK, Chilutti MR, Liu GT, Mccormack SE. Overweight and obesity in pediatric secondary pseudotumor cerebri syndrome. Am J Ophthalmol 2015;159(2):344-52.e1.
5. Görkem SB, Doğanay S, Canpolat M, Koc G, Dogan MS, Per H, et al. MR imaging findings in children with pseudotumor cerebri and comparison with healthy controls. Childs Nerv Syst 2015;31(3):373-80.
6. Değerliyurt A, Teber S, Karakaya G, Güven A, Şeker ED, Arhan EP, et al. Pseudotumor cerebri/idiopathic intracranial hypertension in children: an experience of a tertiary care hospital. Brain Dev 2014;36(8):690-9.
7. Per H, Canpolat M, Gümüş H, Poyrazoğlu HG, Yıkılmaz A, Karaküçük S, et al. Clinical spectrum of the pseudotumor cerebri in children: etiological, clinical features, treatment and prognosis. Brain Dev 2013;35:561-8.
8. Babikian P, Corbett JJ, Bell W. Idiopathic intracranial hypertension in children: The Iowa experience. J Child Neurol 1994;9(2):144-9. 9. Balcer LJ, Liu GT, Forman S, Pun K, Volpe NJ, Galetta SL, et al. Idiopathic intracranial hypertension: relation of age and obesity in children. Neurology 1999;52(4):870-2.
10. Tibussek D, Schneider DT, Vandemeulebroecke N, Turowski B, Messing-Juenger M, Willems PH, et al. Clinical spectrum of the pseudotumor cerebri complex in children. Childs Nerv Syst 2010;26(3):313-21. 11. Brara SM, Koebnick C, Porter AH, Langer-Gould A. Pediatric idiopathic intracranial hypertension and extreme childhood obesity. J Pediatr 2012;161(4):602-7. 12. Kesler A, Fattal-Valevski A. Idiopathic intracranial hypertension in the pediatric population. J Child Neurol 2002;17(10):745-8. 13. Sağlam H, Tarım Ö. Prevalence and correlates of obesity in school children from the city of Bursa, Turkey. J Clin Res Pediatr Endocrinol 2008;1(2):80-8.
14. Glatstein MM, Oren A, Amarilyio G, Scolnik D, Tov AB, Yahav A, et al. Clinical characterization of idiopathic intracranial hypertension in children presenting to the emergency department: the experience of a large tertiary care pediatric hospital. Pediatr Emerg Care 2015;31(1):6-9. 15. Aylward SC, Aronowitz C, Reem R, Rogers D, Roach ES. Intracranial hypertension without headache in children. J Child Neurol 2015;30(6):703-6. 16. Hacifazlioglu Eldes N, Yilmaz Y. Pseudotumour cerebri in children: etiological, clinical features and treatment modalities. Eur J Paediatr Neurol 2012;16(4):349-55. 17. Rangwala LM, Liu GT. Pediatric idiopathic intracranial hypertension. Surv Ophthalmol 2007;52(6):597-617. 18. Phillips PH, Repka MX, Lambert SR. Pseudotumor cerebri in children. J AAPOS 1998;2(1):33-8. 19. Faz G, Butler IJ, Koenig MK. Incidence of papilledema and obesity in children diagnosed with idiopathic ‘’benign’’ intracranial hypertension: case series and review. J Child Neurol 2010;25(11):1389-92.
20. Beri S, Gosalakkal JA, Hussain N, Balky AP, Parepalli S. Idiopathic intracranial hypertension without papilledema. Pediatr Neurol 2010;42(1):56-8. 21. Wall M, Kupersmith MJ, Kieburtz KD, Corbett JJ, Feldon SE, Friedman DI, et al. The idiopathic intracranial hypertension treatment trial. JAMA Neurol 2014;71(6):693-701. 22. Wall M, White WN. Asymmetric papilledema in idiopathic intracranial hypertension: prospective interocular comparison of sensory visual function 2nd. Invest Ophthalmol Vis Sci 1998;39(1):134-42.
23. Degnan AJ, Levy LM. Pseudotumor cerebri: brief review of clinical syndrome and imaging findings. AJNR Am J Neuroradiol 2011;32(11):1986-93.

Yayın Aralığı: 4
Başlangıç: 1916
Yayıncı: İstanbul Üniversitesi Yayınevi

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