Idiopathic Intracranial Hypertension in a Child After Hemodialysis

• Published in: Pediatric neurology Vol. 39; no. 4; pp. 272 - 275
• Main Authors: Ghosh, Sambuddha, MS, Sarkar, Krishnendu, MS, Mukhopadhyay, Subhalakshmi, MD, Bhaduri, Gautam, MS
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2008; Elsevier
• Subjects: Acute Kidney Injury - therapy; Adolescent; Biological and medical sciences; Cerebrospinal fluid. Meninges. Spinal cord; Female; Humans; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Pediatrics; Pseudotumor Cerebri - etiology; Pseudotumor Cerebri - physiopathology; Pseudotumor Cerebri - therapy; Renal Dialysis - adverse effects; Renal Dialysis - methods; Tomography, Optical Coherence; Vision Disorders - etiology; Human; Nervous system diseases; Hemodialysis; Central nervous system disease; Benign intracranial hypertension; Child; Cerebral disorder
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2008.07.007

Idiopathic intracranial hypertension remains a disease of unknown etiology. Epidemiology, associations, features, and prognosis in children have changed over the years. The main clinical complaint of pediatric idiopathic intracranial hypertension is headache with visual disturbance. We report on a patient with childhood idiopathic intracranial hypertension, who presented without headache after hemodialysis for acute renal failure. Idiopathic intracranial hypertension without headache is believed to have a poor prognosis. However, this child demonstrated a favorable outcome with medical therapy. The child was followed with serial optical coherence tomography of retinal nerve fiber layer thickness around the optic nerve head. In the absence of a reliable procedure to evaluate the therapeutic efficacy in the follow-up of patients with idiopathic intracranial hypertension, the importance of optical coherence tomography, a noninvasive, objective, and reproducible procedure, is highlighted as a useful adjunct in the management of idiopathic intracranial hypertension.