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Bulgarian Review of Ophthalmology

Idiopathic intracranial hypertension (IIH) - observations on 6 clinical cases

D. Koleva-Gueorguieva, M. Atanasov, N. Sivkova, S. Krumova, S. Vrabchev, H. Jeliazkov

Abstract

Idiopathic intracranial hypertension (IIH) is a neurological disease that has predominantly ophthalmological clinical signs.

Aim: To perform review of literature and present the long-term observation results on clinical cases with IIH.

Material and methods: The literature review is based on PubMed search of 4057 publications, among which 206 full text articles from the last 5 years. We present and discuss our observations on 6 clinical cases with different clinical characteristics and response to treatment in the long-term follow-up course.

Results: The diagnosis was based on the clinical picture, presence of papilledema, and exclusion of other diseases that can cause intracranial hypertension (check-up of cerebrospinal fluid, cranial CTscan and MRI, exclusion of thrombosis of the cerebral venous sinuses - MRI venography). The first two presented patients underwent neurosurgical treatment (ventriculo-peritoneal shunting), because of the severe course of the disease. The long-term result was unfavorable. The rest 4 patients, due to the moderate severity of the disease, were treated conservatively with high dose Acetazolamide and titration of the dose for a minimum of 9-12 months. In all 4 patients there was successful recovery of visual function, absorbtion of the papilledema and retention of the result for a period of 2 to 4 years.

Conclusion: The correct timely diagnosis and treatment, along with good interdisciplinary collaboration, are the main prerequisite factors that can prevent severe bilateral irreversible loss of visual function in patients with IIH.

Keywords

idiopathic intracranial hypertension; pseudotumor cerebry; acetazolamide; cerebrospinal fluid shunts

Full Text


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DOI: http://dx.doi.org/10.14748/bro.v0i4.4562

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About The Authors

D. Koleva-Gueorguieva
Department of Ophthalmology, 2Department of Neurosurgery Medical University - Plovdiv, UMBAL `Sveti Georgi`, Plovdiv
Bulgaria

M. Atanasov
Department of Ophthalmology, 2Department of Neurosurgery Medical University - Plovdiv, UMBAL `Sveti Georgi`, Plovdiv
Bulgaria

N. Sivkova
Department of Ophthalmology, 2Department of Neurosurgery Medical University - Plovdiv, UMBAL `Sveti Georgi`, Plovdiv
Bulgaria

S. Krumova
Department of Ophthalmology, 2Department of Neurosurgery Medical University - Plovdiv, UMBAL `Sveti Georgi`, Plovdiv

S. Vrabchev
Department of Ophthalmology, 2Department of Neurosurgery Medical University - Plovdiv, UMBAL `Sveti Georgi`, Plovdiv

H. Jeliazkov
Department of Ophthalmology, 2Department of Neurosurgery Medical University - Plovdiv, UMBAL `Sveti Georgi`, Plovdiv

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