Diagnosing and Treating Idiopathic Intracranial Hypertension: Chloe’s Story


It actually goes by a couple names. There’s pseudotumor cerebri, which is which is the more common name in the public’s eye and then there’s
intracranial hypertension. It’s a syndrome involving the cerebral spinal fluid which is a fluid that bathes the brain. It
helped cushion brain provide nutrients and things like that. It has and pressure that it exerts
inside the skull and patients with this
condition that pressure’s actually elevated. The
thoughts are is that there’s an imbalance between the production and
reabsorption of the spinal fluid which then results in increased pressure and
all the symptoms that we see with that. We see all age range of patients. When they’re very young to through adolescence. Chloe was 14 years old when she was referred to us by her eye doctor who had noted the swelling in her
eyes. I went to my eye doctor for Miley he really checkup and they asked to
to take a picture the back of my eye and they looked at my optic nerves and
saw that they were swollen. She did not have any symptoms at the time. We performed the lumbar puncture which noted the increased intracranial pressure and thus completing the diagnosis. My eye doctor at Children’s said that
if we would leave it untreated that I could go blind. Most of our patients we’re able to get
away with medical management. We have medications that decrease the
spinal fluid that you produce to help bring back in that balance. I
take two pills in the morning two pills at night before I go to bed every day. Once the symptoms resolve then we will wean her off the medication and typically we follow patients for about
two years. I think we were very fortunate to catch it as early as we did. She may be one of those fortunate few that do not ever have symptoms other
than just the swelling in the eye or it may be simply that we just caught it
early enough that she hadn’t had time to develop those symptoms yet. We can actually do surgery on the optic
nerve to relieve the pressure on that through cutting essentially cutting
holes in the covering of that optic nerve to relieve the pressure. Some patients also too, can benefit
from diversion of their spinal fluid so
shunting similar to how we do hydrocephalus that our colleagues in neurosurgery perform.And then some patients when their weight is also a factor we refer them to our healthy weight and nutrition clinic. You see the ophthalmologist first. They go through the full exam and get a really good look in the back to the eyes at the nerve
which is the thing most interested in. Then after that they come and see us in neurology where we put that piece of the puzzle together with how they’re doing
clinically in terms of symptoms headaches and things like that and then we come up with the treatment
plan and then also too we have a psychologist that works with in clinic. One of the reasons we chose to go to Children’s was because all the doctors were there together. It’s
on the same day so they don’t need to miss multiple days of school or come back multiple times to clinic.

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