Pseudotumor Cerebri

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Grant T Liu - One of the best experts on this subject based on the ideXlab platform.

  • pediatric Pseudotumor Cerebri syndrome diagnosis classification and underlying pathophysiology
    Seminars in Pediatric Neurology, 2017
    Co-Authors: Claire A Sheldon, Grace L Paley, Shana E. Mccormack, Shannon Beres, Grant T Liu
    Abstract:

    Pseudotumor Cerebri syndrome (PTCS) is defined by the presence of elevated intracranial pressure in the setting of normal brain parenchyma and cerebrospinal fluid. PTCS can occur in the pediatric and adult populations and, if untreated, may lead to permanent visual loss. In this review, discussion will focus on PTCS in the pediatric population and will outline its distinct epidemiology and key elements of diagnosis, evaluation and management. Finally, although the precise mechanisms are unclear, the underlying pathophysiology will be considered.

  • overweight and obesity in pediatric secondary Pseudotumor Cerebri syndrome
    American Journal of Ophthalmology, 2015
    Co-Authors: Grace L Paley, Claire A Sheldon, Evanette Burrows, Marianne Chilutti, Grant T Liu
    Abstract:

    Purpose To examine the clinical, demographic, and anthropometric patient characteristics of secondary Pseudotumor Cerebri syndrome in children and adolescents based on the recently revised diagnostic criteria. Design Retrospective observational case series. Methods Patients seen at a tertiary children’s hospital for Pseudotumor Cerebri syndrome were classified as having either primary idiopathic (n = 59) or secondary Pseudotumor Cerebri syndrome (n = 16), as rigorously defined by recently revised diagnostic criteria. Outcomes included body mass index Z-scores (BMI-Z), height and weight Z-scores, demographics, and clinical features at presentation, such as headache, sixth nerve palsy, and cerebrospinal fluid (CSF) opening pressure. Results In this cohort, the associated conditions and exposures seen in definite secondary Pseudotumor Cerebri syndrome included tetracycline-class antibiotics (n = 11), chronic kidney disease (n = 3), withdrawal from chronic glucocorticoids (n = 1), and lithium (n = 1). Other associations observed in the possible secondary Pseudotumor Cerebri syndrome group included Down syndrome, vitamin A derivatives, and growth hormone. In comparison with primary Pseudotumor Cerebri syndrome, definite secondary Pseudotumor Cerebri syndrome patients were on average older (15.0 vs 11.6 years; P = .003, Mann-Whitney test). According to US Centers for Disease Control (CDC) classifications, 79% of children with secondary Pseudotumor Cerebri syndrome were either overweight or obese (36% overweight [n = 5] and 43% obese [n = 6]), as compared to 32% nationally. Conclusions Even when a potential inciting exposure is identified for pediatric Pseudotumor Cerebri syndrome, the possible contribution of overweight and obesity should be considered.

  • Autism Spectrum Disorder in Pediatric Pseudotumor Cerebri Syndrome
    Spencer S. Eccles Health Sciences Library University of Utah, 2015
    Co-Authors: Anne K. Jensen, Grace L Paley, Claire A Sheldon, Grant T Liu, Shana E. Mccormack
    Abstract:

    "Having recently cared for pediatric patients with suspected Pseudotumor Cerebri syndrome (PTCS) and concurrent autism spectrum disorder (ASD), we examined our cohort for additional evidence of this association.

  • headache and the Pseudotumor Cerebri syndrome
    Current Pain and Headache Reports, 2014
    Co-Authors: Robert M Mallery, Deborah I Friedman, Grant T Liu
    Abstract:

    Pseudotumor Cerebri syndrome (PTCS) refers to the primary and secondary disorders that cause elevated intracranial pressure without an intracranial mass lesion, ventriculomegaly, or central nervous system infection or malignancy. Headache is the most frequent symptom of PTCS, but there is considerable overlap between the headache features of raised intracranial pressure and the headache features of primary headache disorders. We review headache subtypes that occur in PTCS, non-headache features that help distinguish PTCS from other headache types, changes to the diagnostic criteria for PTCS with and without papilledema, and headache treatment strategies as they apply to PTCS.

  • revised diagnostic criteria for the Pseudotumor Cerebri syndrome in adults and children
    Neurology, 2014
    Co-Authors: Deborah I Friedman, Grant T Liu, Kathleen B Digre
    Abstract:

    The Pseudotumor Cerebri syndrome (PTCS) may be primary (idiopathic intracranial hypertension) or arise from an identifiable secondary cause. Characterization of typical neuroimaging abnormalities, clarification of normal opening pressure in children, and features distinguishing the syndrome of intracranial hypertension without papilledema from intracranial hypertension with papilledema have furthered our understanding of this disorder. We propose updated diagnostic criteria for PTCS to incorporate advances and insights into the disorder realized over the past 10 years.

Deborah I Friedman - One of the best experts on this subject based on the ideXlab platform.

  • headache and the Pseudotumor Cerebri syndrome
    Current Pain and Headache Reports, 2014
    Co-Authors: Robert M Mallery, Deborah I Friedman, Grant T Liu
    Abstract:

    Pseudotumor Cerebri syndrome (PTCS) refers to the primary and secondary disorders that cause elevated intracranial pressure without an intracranial mass lesion, ventriculomegaly, or central nervous system infection or malignancy. Headache is the most frequent symptom of PTCS, but there is considerable overlap between the headache features of raised intracranial pressure and the headache features of primary headache disorders. We review headache subtypes that occur in PTCS, non-headache features that help distinguish PTCS from other headache types, changes to the diagnostic criteria for PTCS with and without papilledema, and headache treatment strategies as they apply to PTCS.

  • revised diagnostic criteria for the Pseudotumor Cerebri syndrome in adults and children
    Neurology, 2014
    Co-Authors: Deborah I Friedman, Grant T Liu, Kathleen B Digre
    Abstract:

    The Pseudotumor Cerebri syndrome (PTCS) may be primary (idiopathic intracranial hypertension) or arise from an identifiable secondary cause. Characterization of typical neuroimaging abnormalities, clarification of normal opening pressure in children, and features distinguishing the syndrome of intracranial hypertension without papilledema from intracranial hypertension with papilledema have furthered our understanding of this disorder. We propose updated diagnostic criteria for PTCS to incorporate advances and insights into the disorder realized over the past 10 years.

  • Pseudotumor Cerebri pathophysiology
    Headache, 2014
    Co-Authors: Brian E Mcgeeney, Deborah I Friedman
    Abstract:

    Pseudotumor Cerebri syndrome (PTCS) is an uncommon disorder of raised intracranial pressure of unknown etiology. The signs and symptoms have been well described but the pathogenesis remains a mystery. Most of the evidence suggests increased resistance to cerebrospinal fluid outflow as being pivotal to the disorder. Any comprehensive theory on causation will have to explain the preponderance of obese women of childbearing age with primary PTCS and lack of ventriculomegaly in the disorder. It is possible that female sex hormones, along with endocrinologically active adipose tissue, directly result in the syndrome, in those genetically predisposed. Aldosterone has been proposed also as important in the development of PTCS. Vitamin A, in the form of retinoic acid, may also play a pivotal role, and is influenced by both estrogen and adipose tissue. This article reviews proposed mechanisms of PTCS.

  • Pseudotumor Cerebri
    Spencer S. Eccles Health Sciences Library University of Utah, 2008
    Co-Authors: Deborah I Friedman, Departments Of Ophthalmology And Neurology, University Of Rochester School Of Medicine And Dentistry, New York
    Abstract:

    This one hour presentation on Pseudotumor Cerebri is the first in a series of Neuro-Ophthalmology All Star Grand Rounds. The videolecture is accompanied by written material and is intended as a teaching tool for medical residents. Studies in the 1980s calculated the annual incidence of Pseudotumor Cerebri (PTC) as 0.9/100,000 in the general population, rising to 3.5/100,000 in women 15--44 years and 19.3/100,000 in women ages 20-44 years who are 20% or more above their ideal body weight. With the epidemic of obesity in America, recent studies show that the incidence of PTC has essentially doubled over the past 20 years, with an alarming increase among obese young men.[Garrett, Jacobs] This relatively high frequency ensures that neurologists and ophthalmologists will encounter such patients in their practice and should be familiar with the presentation, diagnosis and management of PTC.Almost all patients (90-95%) with PTC have headache, although occasionally they come to medical attention when papilledema is detected on a routine eye examination. The headache is often daily, retro-ocular and worsened with eye movement.[Giuseffi] Some patients will describe increased severity upon awakening. The headache may also be unilateral, throbbing with nausea, vomiting and photophobia, resembling migraine. Neck and back pain are often prominent features, especially in children. It is not unusual for patients with PTC to have co-existing migraine headaches, making the diagnosis difficult unless other symptoms and signs are present. While headaches are common in PTC, their character is non-specific, and not strongly predictive of the intracranial pressure. Additionally, patients with PTC often have other co-existing headaches, such as migraine or episodic tension-type headache.[Fiedman & Rausch] Chronic daily headaches also raise the possibility of analgesic overuse, which is common in PTC patients, and may worsen their headaches.Baker RS, Buncic JR: Vertical ocular motility disturbances in Pseudotumor Cerebri. J Clin Neuro-ophthalmol 1985;5:41-44 Balcer LJ, Liu GT, Forman S, et al. Idiopathic intracranial hypertension. Relationship of age and obesity in children. Neurology 1999;52:870-872 Brodsky MC, Vaphiades M: Magnetic resonance imaging in Pseudotumor Cerebri. Ophthalmology 1998;105:1686-1693 Burgett RA, Purvin VA, Kawasaki A: Lumboperitoneal shunting for Pseudotumor Cerebri. Neurology 1997;49:734-739 Corbett JJ, Nerad JA, Tse DT, Anderson RL: Results of optic nerve sheath fenestration for Pseudotumor Cerebri. The lateral orbitotomy approach. Arch Ophthalmol 1988;106:1391-1397 Corbett JJ, Thompson HS: The rational management of idiopathic intracranial hypertension. Arch Neurol 1989;46:1049-1051 Cremer PD, Thompson EO, Johnston IH, et al: Pseudotumor Cerebri and cerebral venous hypertension. Neurology 1996;47:1602 Daniels AB, Liu GT, Volpe NJ, et al. Profiles of obesity, weight gain, and quality of life in idiopathic intracranial hypertension (Pseudotumor Cerebri). Am J Ophthalmol 2007;143:635-641. Digre KB, Varner MW, Corbett JJ. Pseudotumor Cerebri and pregnancy. Neurology 1984;34:721-729, 1984. Donnet A, Metellus P, Levrier O, et al. Endovascular treatment of idiopathic intracranial hypertension: Clinical and radiologic outcome of 10 consecutive patients. Neurology 2008;70(8):641-647. Farb RI, Vanek, I, Scott, JN, et al. Idiopathic intracranial hypertension. The prevalence and morphology of sinovenous stenosis. Neurology 2003;60:1418-1424. Frisén L: Swelling of the optic nerve head: a staging scheme. J Neurol Neurosurg Psychiatry 45:13-18, 1982 Friedman DI, Forman S, Levi L, et al: Unusual ocular motility disturbances with increased intracranial pressure. Neurology 1998;50:1893-1896 Friedman DI, Ingram P: The effect of sulfa conjugated medications on intracranial hypertension in patients with idiopathic intracranial hypertension. Ann Neurol 1998;44:499 Friedman DI, Jacobson DM. Diagnostic criteria for idiopathic intracranial hypertension. Neurology 59:1492-1495, 2002. Friedman DI, Rausch EA. Headache diagnoses in patients with treated idiopathic intracranial hypertension. Neurology 58:1551-1553, 2002. Friedman DI, Streeten DHP: Idiopathic intracranial hypertension and orthostatic edema may share a common pathogenesis. Neurology 50:1099-1104, 1998 Frohman LP, Kupersmith MJ: Reversible vertical ocular deviations associated with raised intracranial pressure. J Clin Neuro-ophthalmol 5:158-163, 1985 Garrett JH, Corbett JJ, Braswell R: The incidence of idiopathic intracranial hypertension in Mississippi. Orlando, Florida. North American Neuro-Ophthalmology Society. 2004;86 Garton HJL: Cerebrospinal fluid diversion procedures. J Neuro-Ophthalmol 2004;24:146-155. Giuseffi V, Wall M, Siegel PZ, et al: Symptoms and disease associations in idiopathic intracranial hypertension( Pseudotumor Cerebri): A case-control study. Neurology 1991;41:239-244 Higgins JNP, Cousins C, Owler BK, et al. Idiopathic intracranial hypertension: 12 cases treated by venous sinus stenting. J Neurol Neurosurg Psychiatry 2003;74:1662-1666. Ireland B, Corbett JJ, Wallace RB: The search for causes of idiopathic intracranial hypertension. A Preliminary case-control study. Arch Neurol 1990;47:315-320 Jacobs DA, Corbett JJ, Balcer LJ: Annual incidence of idiopathic intracranial hypertension (IIH) in the Philadephia area. Orlando, FL. North American Neuro-Ophthalmology Society. 2004;286 Jacobson DM, Jaranjia PN, Olson KA, et al: Computed tomography ventricular size has no predictive value in diagnosing Pseudotumor Cerebri. Neurology 1990;40:1454-1455 Johnson LN, Krohel GB, Madsen RW, March GA: The role of weight loss and acetazolamide in the treatment of idiopathic intracranial hypertension (Pseudotumor Cerebri). Ophthalmology 1998;105:2313-2317 Johnston M, Zakharov A, Papaiconomou C, Salmasi G, Armstrong D. Evidence of connections between cerebrospinal fluid and nasal lymphatic vessels in humans, non-human primates and other mammalian species. Cerebrospinal Fluid Res 2004;1(2):1-13. Jennum P, Borgesen SE: Intracranial pressure and obstructive sleep apnea. Chest 1989;95:279-283 Keltner JL: Optic nerve sheath decompression. How does it work? Has its time come? Arch Ophthalmol 1988;106:1365-1369 Kleinschmidt JJ, Digre KB, Hanover R. Idiopathic intracranial hypertension: Relationship to depression, anxiety and quality of life. Neurology 54:319-324, 2000 Kupersmith MJ, Gamell L, Turbin R, Peck V, Spiegel P, Wall M: Effects of weight loss on the course of idiopathic intracranial hypertension in women. Neurology 1998;50:1094-1098 Lam BL, Schatz NJ, Glaser JS, et al: Pseudotumor Cerebri from cranial venous obstruction. Ophthalmology 99:706-712, 1992 Lee AG, Pless M, Falardeau J, et al. The use of acetazolamide in idiopathic intracranial hypertension during pregnancy. Am J Ophthalmol 2005;139(5):855-9 Lessell S. Pediatric Pseudotumor Cerebri (idiopathic intracranial hypertension). Surbv Ophthalmol 37:144-166, 1992 Lin A, Foroozan R, Danesh-Meyer HV, et al. Occurrence of cerebral venous sinus thrombosis in patients with presumed idiopathic intracranial hypertension. Ophthalmology 2006;113:2281-2284 Lindvall-Axelsson M, Mather C, Nilsson C: Effect of 5-hydroxytriptamine on the rate of cerebrospinal fluid production in rabbit. Exp Neurol 99:362-368, 1988 Liu GT, Glaser JS, Schatz NJ: High dose methylprednisolone and acetazolamide for visual loss in Pseudotumor Cerebri. Am J Ophthalmol 1994;118:88-96 Liu GT, Kay MD, Bienfang DC, Schatz NJ: Pseudotumor Cerebri associated with corticosteroid withdraw in inflammatory bowel disease. Am J Ophthalmol 1994;117:352-357 McGirt MJ, Woodworth G, Thomas G, et al. Cerebrospinal fluid shunt placement for Pseudotumor Cerebri-associated intractable headache: predictors of treatment response and an analysis of long-term outcomes. J Neurosurg 2004;101:627-632 Marcelis J, Silberstein SD: Idiopathic intracranial hypertension without papilledema. Arch Neurol 48:392-399, 1991 Neville L, Egan RA. Frequency and amplitude of cerebrospinal fluid pressure resting pressure by the Valsalva maneuver. Can J Ophth 2005;40:775-777 Owler BK, Parker G, Halmagyi GM, et al. Pseudotumor Cerebri syndrome: venous sinus obstruction and its treatment with stent placement. J Neurosurg 2003;98:1045-1055. Nilsson C, Lindvall-Axelsson M, Owman C: Sympathetic nervous control of cerebrospinal fluid production from the choroid plexus. Science 201:176-178, 1978 Plotnik JL, Kosmorsky GS: Operative complications of optic nerve sheath decompression. Ophthalmology 1993;100:683-690 Rangwala LM, Liu GT. Pediatric Idiopathic Intracranial Hypertension. Surv Ophthalmol 2007;52(6):597-617 Rosenberg ML, Corbett JJ, Smith C, et al: Cerebrospinal fluid diversion procedures in Pseudotumor Cerebri. Neurology 1993;43:1071-1072 Round R, Keane JR: The minor symptoms of increased intracranial pressure: 101 patients with benign intracranial hypertension. Neurology 1988;38:1461-1461 Rubin RC, Henderson ES, Ommaya AK, Walker MD, Rall DP: The production of cerebrospinal fluid in man and its modification by acetazolamide. J Neurosurg 1966;25:430-436 Scher AI, Stewart WF, Ricci JA, Lipton RB: Factors associated with the onset and remission of chronic daily headache in a population-based study. Pain 2003;106:81-89 Sergott RC, Savino PJ, Bosley TM: Modified optic nerve sheath decompression provides long-term visual improvement for Pseudotumor Cerebri. Arch Ophthalmol 1988;106:1384-1390 Silbergleit R, Junck L, Gebarski SS, et al: Idiopathic intracranial hypertension (Pseudotumor Cerebri): MR imaging. Neuroradiol 170:207-208, 1989 Sismanis A, Hughes GB, Abedi E, et al: Otologic symptoms and findings of the Pseudotumor Cerebri syndrome: A preliminary report. Otolaryngol Head Neck Surg 93:398-402, 1985 Spoor TC, McHenry JG: Long-term effectiveness of optic nerve sheath decompression for Pseudotumor Cerebri. Arch Ophthalmol 1993;111:632-635 Stiebel-Kalish H, Kalish Y, Lusky M, et al. Puberty as a risk factor for less favorable visual outcome in idiopathic intracranial hypertension. Am J Ophthalmol 2006;142(2):279-283 Sugarman HJ, Felton WL, Sismanis A, et al: Gastric surgery for Pseudotumor Cerebri associated with severe obesity. Ann Surg 1999;229:634-642 Thambisetty M, Lavin PJ, Newman NJ, Biousse V. Fulminant idiopathic intracranial hypertension. Neurology 2007;68(3):229-232 Verplanck M. Kaufman DI, Parsons T, et al: Electrophysiology versus psychophysics in the detection of visual loss in Pseudotumor Cerebri. Neurology 1988;38:1789-1792 Wall M: Sensory visual testing in idiopathic intracranial hypertension: measures sensitive to change. Neurology 1990;40:1859-1864 Wall M, George D: Idiopathic intracranial hypertension (Pseudotumor Cerebri): A prospective study of 50 patients. Brain 114(Pt. A):115-180, 1991 Wall M, George D: Visual loss in Pseudotumor Cerebri. Incidence and defects related to visual field strategy. Arch Neurol 1987;44:170-175 Wall M, White WN II: Asymmetric papilledema in idiopathic intracranial hypertension: Prospective interocular comparison of sensory visual function. Invest Ophthalmol Vis Sci 39:132-142, 1998 Wang S-J, Silberstein SD, Patterson S, et al: Idiopathic intracranial hypertension without papilledema. A case-control study in a headache center. Neurology 51:245-249, 1998 Wolin MJ, Brannon WL (with comments by Kay MD, Hupp SL): Disk edema in an overweight woman. Surv Ophthalmol 1995;39:307-31

  • Walsh & Hoyt: Pseudotumor Cerebri: Definition
    Spencer S. Eccles Health Sciences Library University of Utah, 2005
    Co-Authors: Deborah I Friedman, Neurology & Neurotherapeutics, University Of Texas Southwestern
    Abstract:

    The Pseudotumor Cerebri syndrome was first described by Quincke in 1897. The terminology used historically in the literature gives a sense of the various conditions associated with Pseudotumor Cerebri (PTC): toxic hydrocephalus, otitic hydrocephalus, hypertensive meningeal hydrops, pseudoabscess, ICP without brain tumor, brain swelling of unknown cause, and papilledema of indeterminate etiology. The most popular and enduring term Pseudotumor Cerebri was first used in 1914. Noting that the condition was not caused by a tumor or malignancy, Foley introduced the term benign intracranial hypertension in 1955. However, the term benign also implies a favorable process or the absence of harm. As significant visual morbidity may result from PTC, the use of the prefix benign was challenged and is no longer considered acceptable terminology. The disorder is most correctly termed idiopathic intracranial hypertension (IIH) or intracranial hypertension from a secondary cause, depending upon whether or not n etiology is identified. The older term, PTC, describes the clinical syndrome without reference to the underlying cause

Simmons Lessell - One of the best experts on this subject based on the ideXlab platform.

  • pediatric Pseudotumor Cerebri idiopathic intracranial hypertension
    Survey of Ophthalmology, 1992
    Co-Authors: Simmons Lessell
    Abstract:

    This review focuses on the features of Pseudotumor Cerebri in the pediatric age group. There is no sex predilection in children, and obesity does not appear to be an important factor. Infants and young children may present with irritability, apathy, or somnolence, rather than headache. Dizziness and ataxia may also occur. Papilledema is infrequently noted in pediatric patients if the fontanelles are open or the sutures are split. Pre-adolescents appear more likely than adults or adolescents to have manifestations of their Pseudotumor Cerebri other than headache and papilledema, including lateral rectus pareses, vertical strabismus, facial paresis, back and neck pain. Among the etiologies that are particularly pertinent to children are tetracycline therapy, malnutrition or renutrition, and the correction of hypothyroidism. Children with Pseudotumor Cerebri are at risk for visual loss and their visual function must be closely monitored. Surgical intervention is imperative when vision is threatened.

Grace L Paley - One of the best experts on this subject based on the ideXlab platform.

  • pediatric Pseudotumor Cerebri syndrome diagnosis classification and underlying pathophysiology
    Seminars in Pediatric Neurology, 2017
    Co-Authors: Claire A Sheldon, Grace L Paley, Shana E. Mccormack, Shannon Beres, Grant T Liu
    Abstract:

    Pseudotumor Cerebri syndrome (PTCS) is defined by the presence of elevated intracranial pressure in the setting of normal brain parenchyma and cerebrospinal fluid. PTCS can occur in the pediatric and adult populations and, if untreated, may lead to permanent visual loss. In this review, discussion will focus on PTCS in the pediatric population and will outline its distinct epidemiology and key elements of diagnosis, evaluation and management. Finally, although the precise mechanisms are unclear, the underlying pathophysiology will be considered.

  • MRI Findings in Children with Pseudotumor Cerebri Syndrome (PTCS), Intracranial Hypertension, and Normal Opening Pressure without Papilledema (.pdf)
    Spencer S. Eccles Health Sciences Library University of Utah, 2016
    Co-Authors: Anita A. Kohli, Grace L Paley, Claire A Sheldon, Arastoo Vossough, Grant Liu, Robert Mallery, Shana Mccormack, Christina L. Szperka
    Abstract:

    Revised diagnostic criteria for Pseudotumor Cerebri syndrome (PTCS) include findings on neuroimaging, which can be used if papilledema is not present. We compared neuroimaging in children suspected to have PTCS, in order to facilitate the identification and treatment

  • overweight and obesity in pediatric secondary Pseudotumor Cerebri syndrome
    American Journal of Ophthalmology, 2015
    Co-Authors: Grace L Paley, Claire A Sheldon, Evanette Burrows, Marianne Chilutti, Grant T Liu
    Abstract:

    Purpose To examine the clinical, demographic, and anthropometric patient characteristics of secondary Pseudotumor Cerebri syndrome in children and adolescents based on the recently revised diagnostic criteria. Design Retrospective observational case series. Methods Patients seen at a tertiary children’s hospital for Pseudotumor Cerebri syndrome were classified as having either primary idiopathic (n = 59) or secondary Pseudotumor Cerebri syndrome (n = 16), as rigorously defined by recently revised diagnostic criteria. Outcomes included body mass index Z-scores (BMI-Z), height and weight Z-scores, demographics, and clinical features at presentation, such as headache, sixth nerve palsy, and cerebrospinal fluid (CSF) opening pressure. Results In this cohort, the associated conditions and exposures seen in definite secondary Pseudotumor Cerebri syndrome included tetracycline-class antibiotics (n = 11), chronic kidney disease (n = 3), withdrawal from chronic glucocorticoids (n = 1), and lithium (n = 1). Other associations observed in the possible secondary Pseudotumor Cerebri syndrome group included Down syndrome, vitamin A derivatives, and growth hormone. In comparison with primary Pseudotumor Cerebri syndrome, definite secondary Pseudotumor Cerebri syndrome patients were on average older (15.0 vs 11.6 years; P = .003, Mann-Whitney test). According to US Centers for Disease Control (CDC) classifications, 79% of children with secondary Pseudotumor Cerebri syndrome were either overweight or obese (36% overweight [n = 5] and 43% obese [n = 6]), as compared to 32% nationally. Conclusions Even when a potential inciting exposure is identified for pediatric Pseudotumor Cerebri syndrome, the possible contribution of overweight and obesity should be considered.

  • Autism Spectrum Disorder in Pediatric Pseudotumor Cerebri Syndrome
    Spencer S. Eccles Health Sciences Library University of Utah, 2015
    Co-Authors: Anne K. Jensen, Grace L Paley, Claire A Sheldon, Grant T Liu, Shana E. Mccormack
    Abstract:

    "Having recently cared for pediatric patients with suspected Pseudotumor Cerebri syndrome (PTCS) and concurrent autism spectrum disorder (ASD), we examined our cohort for additional evidence of this association.

Claire A Sheldon - One of the best experts on this subject based on the ideXlab platform.

  • pediatric Pseudotumor Cerebri syndrome diagnosis classification and underlying pathophysiology
    Seminars in Pediatric Neurology, 2017
    Co-Authors: Claire A Sheldon, Grace L Paley, Shana E. Mccormack, Shannon Beres, Grant T Liu
    Abstract:

    Pseudotumor Cerebri syndrome (PTCS) is defined by the presence of elevated intracranial pressure in the setting of normal brain parenchyma and cerebrospinal fluid. PTCS can occur in the pediatric and adult populations and, if untreated, may lead to permanent visual loss. In this review, discussion will focus on PTCS in the pediatric population and will outline its distinct epidemiology and key elements of diagnosis, evaluation and management. Finally, although the precise mechanisms are unclear, the underlying pathophysiology will be considered.

  • MRI Findings in Children with Pseudotumor Cerebri Syndrome (PTCS), Intracranial Hypertension, and Normal Opening Pressure without Papilledema (.pdf)
    Spencer S. Eccles Health Sciences Library University of Utah, 2016
    Co-Authors: Anita A. Kohli, Grace L Paley, Claire A Sheldon, Arastoo Vossough, Grant Liu, Robert Mallery, Shana Mccormack, Christina L. Szperka
    Abstract:

    Revised diagnostic criteria for Pseudotumor Cerebri syndrome (PTCS) include findings on neuroimaging, which can be used if papilledema is not present. We compared neuroimaging in children suspected to have PTCS, in order to facilitate the identification and treatment

  • overweight and obesity in pediatric secondary Pseudotumor Cerebri syndrome
    American Journal of Ophthalmology, 2015
    Co-Authors: Grace L Paley, Claire A Sheldon, Evanette Burrows, Marianne Chilutti, Grant T Liu
    Abstract:

    Purpose To examine the clinical, demographic, and anthropometric patient characteristics of secondary Pseudotumor Cerebri syndrome in children and adolescents based on the recently revised diagnostic criteria. Design Retrospective observational case series. Methods Patients seen at a tertiary children’s hospital for Pseudotumor Cerebri syndrome were classified as having either primary idiopathic (n = 59) or secondary Pseudotumor Cerebri syndrome (n = 16), as rigorously defined by recently revised diagnostic criteria. Outcomes included body mass index Z-scores (BMI-Z), height and weight Z-scores, demographics, and clinical features at presentation, such as headache, sixth nerve palsy, and cerebrospinal fluid (CSF) opening pressure. Results In this cohort, the associated conditions and exposures seen in definite secondary Pseudotumor Cerebri syndrome included tetracycline-class antibiotics (n = 11), chronic kidney disease (n = 3), withdrawal from chronic glucocorticoids (n = 1), and lithium (n = 1). Other associations observed in the possible secondary Pseudotumor Cerebri syndrome group included Down syndrome, vitamin A derivatives, and growth hormone. In comparison with primary Pseudotumor Cerebri syndrome, definite secondary Pseudotumor Cerebri syndrome patients were on average older (15.0 vs 11.6 years; P = .003, Mann-Whitney test). According to US Centers for Disease Control (CDC) classifications, 79% of children with secondary Pseudotumor Cerebri syndrome were either overweight or obese (36% overweight [n = 5] and 43% obese [n = 6]), as compared to 32% nationally. Conclusions Even when a potential inciting exposure is identified for pediatric Pseudotumor Cerebri syndrome, the possible contribution of overweight and obesity should be considered.

  • Autism Spectrum Disorder in Pediatric Pseudotumor Cerebri Syndrome
    Spencer S. Eccles Health Sciences Library University of Utah, 2015
    Co-Authors: Anne K. Jensen, Grace L Paley, Claire A Sheldon, Grant T Liu, Shana E. Mccormack
    Abstract:

    "Having recently cared for pediatric patients with suspected Pseudotumor Cerebri syndrome (PTCS) and concurrent autism spectrum disorder (ASD), we examined our cohort for additional evidence of this association.

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