IH Registry and Pediatric Intracranial Hypertension
IH Registry Study on Pediatric Intracranial Hypertension published in Pediatric Neurology
Children represent one of the fastest growing groups of IH patients, yet there has been relatively little research on this group. A new IH Registry study focusing on pediatric intracranial hypertension was recently published in the journal Pediatric Neurology. Researchers at the IH Registry and at Nationwide Childrens’ Hospital in Columbus, Ohio examined different aspects of how the disorder affected both pre-pubertal and post-pubertal children.
The study’s goal was to examine the presenting symptoms, demographics, and interventions in pediatric patients enrolled in the Intracranial Hypertension Registry. Among other discoveries, the researchers found significantly higher rates of obesity in postpubertal females with primary intracranial hypertension. The female-to-male ratios in the postpubertal primary intracranial hypertension and secondary intracranial hypertension groups were also higher than reported in the medical literature.
A total of 203 IH Registry patients—the largest group of pediatric patients examined in such a study—met the criteria for inclusion; 142 (70%) were considered primary (i.e.idiopathic) intracranial hypertension. All patients were 18 years old or less when first diagnosed. Females made up 72.5% (103 of 142) and 75.8% (47 of 61) in the primary intracranial hypertension (PIH) and secondary intracranial hypertension (SIH) groups, respectively. When divided into pre- and postpubertal status, 32.5% of patients were classified prepubertal; 77.3% of these had primary intracranial hypertension. This resulted in a female to male ratio of 1:1.04 for prepubertal and 6:1 for post pubertal primary intracranial hypertension patients. The body mass index was significantly higher in the postpubertal primary intracranial hypertension group (P = 0.0014). There was no significant difference in opening pressure.
Some of the study’s other discoveries:
•Symptoms most often reported were headache and blurred vision in both PIH and SIH groups.
•Tinnitus was reported in 44.3% of PIH patients and 49.1% of SIH patients in the Registry’s cohort. Tinnitus has been previously estimated at 10% of pediatric PIH patients.
•Bilateral disc edema (papilledema) occurred in 89.3% of the primary IH patients, and in 78.7% of secondary intracranial hypertension patients.
•The most common cause of SIH among the patients studied was the tetracycline drug family, which has long been associated with increased intracranial hypertension.
•The BMI was higher in the postpubertal group at 30.7 compared with 21.6 in the prepubertal group.
•SIH patients with an opening pressure of less than 28 cm of H20 were less likely to have optic nerve edema when compared with those with 28 cm of H20 (66.7% versus 84.1%). PIH and SIH patients with opening pressure less than 28 cm of H20 were less likely to have a CN VI (seventh cranial nerve) palsy. This finding suggests that there may be a yet unclear link between the degree of increased pressure and development of the palsy.
•SIH patients (62.3%, 38 of 61) were more likely than PIH patients (33.8%, 48 of 142) to have surgical interventions.
Additionally, the common symptoms of intracranial hypertension, including headache, optic disc edema, and vision changes, occurred with similar frequencies in the Registry’s cohort to those reported in the medical literature.
For more information about this study, please read the PubMed abstract.