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Papers of the Week

Papers: 9 Sep 2023 - 15 Sep 2023

Basic Science, Pediatric

Human Studies, Neurobiology

Migraine/Headache, Psychological/Comorbidities

2023 Sep 11

Eur J Pediatr


Predictors of disease course and long-term outcomes of idiopathic intracranial hypertension in children and adolescents.


Senderowich N, Bachar-Zipori A, Mitelpunkt A, Latzer IT, Klein A, Mezad-Koursh D, Fattal-Valevski A, Hausman-Kedem M


This study aimed to identify predictors for unfavorable disease course and clinical and visual outcomes in pediatric patients with idiopathic intracranial hypertension (IIH). Employing a multi-tiered approach, we retrospectively analyzed clinical, ophthalmic, and neuroimaging data from patients diagnosed with IIH between 2003 and 2021. Of the 97 patients included, 56 (58%) were females. The median age was 12 years [Interquartile range (IQR) 9, 14], and the median follow-up time was 39.0 months (IQR 14.8, 90.9). Forty-two (43%) patients had an unfavorable disease course, 28 (29%) had persistence of headache at last follow-up, and 16 (18%) had a poor visual outcome, most of them with mild visual disturbances. Poor visual outcome was more common in females compared to males [16/47 (34%) vs. 0/39, p < 0.001)]. On multivariate regression analysis, female sex and disease recurrence were significantly associated with poor visual outcomes (OR: 18.5, CI:1.3-270, P = 0.03, and OR: 5.1, CI: 1.2-22.5, P = 0.03, respectively). Patients with persistent headaches exhibited lower incidence of papilledema, lower opening pressure, and fewer neuroimaging markers indicating elevated intracranial pressure.