Secondary pseudotumor cerebri in the pediatric population: clinical features, treatment, and prognosis

Abstract

Purpose: Pseudotumor cerebri syndrome (PTCS) is characterized by elevated intracranial pressure (ICP) without intracranial mass, hydrocephalus, or abnormalities in cerebrospinal fluid (CSF) composition. In secondary PTCS (sPTCS), there is a reason that increases the CSF pressure. The aim of this study is to evaluate the diagnosis, treatment, and follow-up of pediatric patients diagnosed with sPTCS. Materials and methods: This is a retrospective study conducted in a single-center tertiary pediatric hospital. We included patients aged 1-17 years who were diagnosed with sPTCS in a tertiary hospital between 2018 and 2023 and met the current diagnostic criteria for PTCS. We evaluated the complaints, etiology, ophthalmological evaluations, and treatment results of the cases. Results: Seventeen patients with a diagnosis of PTCS were included in the study. The mean age was 9.82 (±4.6). Of the patients, 9 (56.2%) were male and 8 (43.7%) were female. The most common symptoms were headache in 10 patients (62.5%), nausea/vomiting in 6 patients (37.5%), and double vision in 5 patients (31.2%). All patients had papilledema and 7 (43.7%) patients had sixth nerve palsy. Recurrence was observed in 3 (16%) patients. Optic nerve fenestration was performed in three patients as a second-line treatment. Conclusion: In cases that do not respond to medical treatment, optic nerve sheath fenestration may be a good treatment option.