Identification of Underlying Causes of Papilledema in Children
Mehmet C. Mocan, MD; Urmi Sheth; Robert Hyde, MD, PhD; Lawrence Kaufman, MD, PhD
University of Illinois at Chicago
Introduction: There are limited studies looking into the underlying disorders of intracranial disorders in pediatric patients who present with papilledema. The purpose of this retrospective study is to identify the types and relative frequencies of intracranial disorders in pediatric patients who present with papilledema.
Methods: This was a retrospective study conducted in two clinical settings. Pediatric patients aged between 0-16 years diagnosed with papilledema and who had imaging studies of the head performed at the time of the diagnosis were included in the study. Patient demographic data, ophthalmologic examination findings and underlying causes of papilledema were identified from clinical records.
Results: The mean age of 36 study patients (18F, 18M) was 8.8±4.8 years. Of the 36 patients, 16 (44.4%) had idiopathic intracranial hypertension (IIH), 6 (16.7%) had intracranial tumors, 6 (16.7%) had craniosynostosis, 2 (5.5%) had primary hydrocephalus, 1 (2.8%) had transverse sinus thrombosis related to mastoiditis, 1 (2.8%) had intracranial abscess, 1 (2.8%) had presumed neurosarcoidosis, 1 (2.8%) had Lyme’s disease, 1 (2.8%) had acute disseminated encephalomyelitis, and 1 (2.8%) had malignant hypertension. Of the six intracranial tumors, two (33.3%) presented in the sellar/parasellar region, two (33.3%) in the posterior fossa and two (33.3%) were located in cortical locations.
Discussion: IIH is the most frequent underlying disorder in pediatric patients presenting with papilledema in this cohort.
Conclusion: Clinicians should have a high index of suspicion for IIH in children presenting with papilledema, particularly if there is no history of coexisting medical problems.
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