In postpubertal children, IIH is typically seen in overweight girls; however, in prepubertal children, boys and girls are equally affected [41]. Several secondary causes of pseudotumor cerebri have been described, including cerebral venous anomalies, intracranial arteriovenous fistulas, medications (tetracyclines, Vitamin A, retinoids, steroids, growth hormone, thyroxine, lithium, etc), and endocrine disorders (Addison disease, hypoparathyroidism, etc) [42]. Diagnostic criteria for pseudotumor cerebri syndrome include papilledema, normal neurological examination (except sixth nerve palsy), normal brain parenchyma on imaging (with absence of mass, hydrocephalus, or abnormal meningeal enhancement), normal cerebrospinal fluid composition, and elevated lumbar puncture opening pressure >280 mm of cerebrospinal fluid in children (or >250 mm cerebrospinal fluid if the child is not sedated and not obese) [42]. In the absence of papilledema and sixth nerve palsy, diagnosis of pseudotumor cerebri can be suggested on neuroimaging based on findings including empty sella, flattening of the posterior aspect of the globes, distention of the perioptic subarachnoid space, and transverse sinus stenosis [42]. This variant includes older infants or older children therefore head ultrasonography is not an optimal imaging option. CT Head and Orbits There is no relevant literature to support the use of CT head and orbits in the initial evaluation of children with papilledema or suspected raised intracranial pressure. Orbital Imaging and Vision Loss-Child CT Head CT of the head without IV contrast may be a useful and alternative modality to MRI head for the evaluation of intracranial space occupying lesion or hydrocephalus causing raised intracranial pressure and papilledema. There is no relevant literature to support the use of contrast-enhanced CT head in the initial evaluation of children with papilledema or suspected raised intracranial pressure.
Orbital Imaging and Vision Loss Child. In postpubertal children, IIH is typically seen in overweight girls; however, in prepubertal children, boys and girls are equally affected [41]. Several secondary causes of pseudotumor cerebri have been described, including cerebral venous anomalies, intracranial arteriovenous fistulas, medications (tetracyclines, Vitamin A, retinoids, steroids, growth hormone, thyroxine, lithium, etc), and endocrine disorders (Addison disease, hypoparathyroidism, etc) [42]. Diagnostic criteria for pseudotumor cerebri syndrome include papilledema, normal neurological examination (except sixth nerve palsy), normal brain parenchyma on imaging (with absence of mass, hydrocephalus, or abnormal meningeal enhancement), normal cerebrospinal fluid composition, and elevated lumbar puncture opening pressure >280 mm of cerebrospinal fluid in children (or >250 mm cerebrospinal fluid if the child is not sedated and not obese) [42]. In the absence of papilledema and sixth nerve palsy, diagnosis of pseudotumor cerebri can be suggested on neuroimaging based on findings including empty sella, flattening of the posterior aspect of the globes, distention of the perioptic subarachnoid space, and transverse sinus stenosis [42]. This variant includes older infants or older children therefore head ultrasonography is not an optimal imaging option. CT Head and Orbits There is no relevant literature to support the use of CT head and orbits in the initial evaluation of children with papilledema or suspected raised intracranial pressure. Orbital Imaging and Vision Loss-Child CT Head CT of the head without IV contrast may be a useful and alternative modality to MRI head for the evaluation of intracranial space occupying lesion or hydrocephalus causing raised intracranial pressure and papilledema. There is no relevant literature to support the use of contrast-enhanced CT head in the initial evaluation of children with papilledema or suspected raised intracranial pressure.