| Popis: |
Background: Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure and typical symptomas including headache, nausea, vomiting, decreased visual acuity or double vision. Methods: We report six patients, 4 men and 2 women, mean age 34 ± 6, with IIH, diagnosed by typical clinical symptoms and confi rmed by increased intracranial pressure. Results: We evaluated the most common clinical symptoms, including typical predisposal factors as obesity, diabetes and other endocrinologic disorders, magnetic resonance imiging (MRI) of brain, pressure of cerebrospinal fl uid (CSF) measured by lumbar puncture and tests of visual fi eld. Headache was present in 3 patients, nausea and vomitig in 2 of them and the most common symptom was decreased visual acuity which was present in all patients. One patient had recidive transient visual obscurations while in others visual disturbances were constantly present. Both female patients were obese, one had insulin dependent diabetes and one had struma of thyroid gland. MRI showed signs of empty sella in one patient, while in others was normal. All patients had increased CSF pressure, 40-60 cm H20. Visual fi eld testing showed pathologic fi ndings in all patients as papilledema, visual loss in the periphery and optic atrophy in advanced stages. Four patients was treated conservatively with acetazolamide with relief of typical symptoms and improved visual function. Two of them failed to improve after initial medical treatment and lumboperitoneal shunt was done. In six months follow-up period one patient improved. Conclusion: IIH is a chronic neurologic disorder which untreated leads to visual loss and blindness. In cases of unsuccessful medical treatment, surgical procedure should be considered as an alternative treatment option. |
