İdyopatik intrakranyal hipertansiyon: Klinik, laboratuvar özellikleri ve prognoz

Amaç: Bu çalışmada idyopatik intrakranyal hipertansiyon (İİH) olgularının klinik semptom ve bulguları, demografik özellikleri ve prognozları araştırıldı. Hastalar ve Yöntemler: Modifiye Dandy kriterlerine göre idyopatik intrakranyal hipertansiyon tanısı almış, on yıllık bir süredir izlenen 21 hasta (18 kadın, 3 erkek; ort. yaş 34.9; dağılım 16-50) çalışmaya alındı. Bütün hastaların başvuru yakınmaları, tıbbi öyküleri, hemogram, biyokimya ve görüntüleme incelemeleri, göz dibi bakıları kaydedilerek değerlendirildi. Bulgular: En sık gözlenen yakınma baş ağrısıydı (%85.7), bunu vizüel semptomlar (%47.6), tinnitus (%19.0) ve bulantı- kusma (%38.1) izliyordu. Hastaların 15'inde (%71.4) papilla ödemi, dördünde (%19.0) optik diskte nazal veya temporal siliklik saptandı, kalan iki hastada (%9.5) fundus muayenesi normaldi. Sekiz hastada (%38.1) beyin ödemi saptandı. Görsel uyandırılmış potansiyel kaydı yapılan 16 hastanı n dördünde (%25) P100 latansında uzama gözlendi. Ortalama sekiz aylık takip süresinin sonunda hastaların baş ağrısı ve vizüel semptomlarında belirgin düzelme oldu. Sonuç: Sonuç olarak, İİH genellikle benign karakterli bir tablodur ancak nadiren kalıcı görme kaybına da neden olabilir. Bu nedenle baş ağrısı, görme ve işitme bozukluğu yakınmalarıyla başvuran genç, kilolu kadın hastalarda İİH tanısı da akılda bulundurulmalıdır.

Idiopathic intracranial hypertension: Clinical, laboratory features and prognosis

Objectives: In this study, we evaluated the clinical symptoms and findings, demographic features and prognosis of patients with idiopathic intracranial hypertenson (IIH). Patients and Methods: Twenty-one patients (18 women, 3 men; mean age 34.9 years; range 16 to 50 years) who fulfilled the modified Dandy's diagnostic criteria for IIH and were followed in the last 10 years, were included in the study. The presenting complaints, medical history, laboratory data including blood count and routine biochemical assessments, imaging and ophtalmoscopic evaluation data were evaluated. Results: Headache was the primary symptom (85.7%) on admission. The other presenting symptoms were visual impairment (47.6%), tinnitus (19.0%), nausea-vomiting (38.1%). Papilledema was found in 15 patients (71.4%), nasal and temporal swollen of optic disc in 4 patients (19.0%). Two patients had normal fundus examination. Eight (38.1%) had brain edema. Four out of 16 patients who underwent visual evoked potential, had prolonged P100 latency. Headache and visual symptoms were improved within 8 months follow-up period. Conclusion: In conclusion, although idiopathic intracranial hypertenson has good prognosis, it may rarely cause permanent visual loss. For this reason, IIH should be considered in young and obese women presenting with headache, visual and auditive symptoms.

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