良性颅内高压的临床表现及治疗(法国)

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Introduction. Benign intracranial hypertension (BIH) or pseudotumor cerebri i s diagnosed on the basis of Dandy’s criteria. BIH creates an emergency situati on because of the risk of lost vision. In this work, we studied retrospectively a series of 10 cases of BIH all meeting Dandy’s criteria. Our objective was to assess the benefit of the corticosteroid-acetazolamide combination on clinica l course, especially on papiledema. Methods. Eighty-four patients were hospita lized at the neurology department (H pital des Spé cialité s, Rabat) over a period of 14 years (1988- 2001). They were divided into three groups: forty cas es of cerebral thromophlebitis, 10 cases of BIH. In the remaining 34 cases, the investigations were insufficient, so that Dandy’s criteria could not be verifi ed. We studied only the 10 cases presenting with a diagnosis of BIH diagnosis co mplying with Dandy’s criteria. The patients underwent a physical examination, cerebral magnetic resonance imaging (MRI) if possible or CT scan with convention al angiography, and CSF examination with pressure measurement. We analyzed age, sex-ratio, clinical aspects and the outcome after treatment. The major criteri on of outcome was the regression of papilledema. Results. There were 9 women and 1 man. The mean age was 24.6 ± 8.4 years. Behcet’s disease was noted in 3/10 patients. The clinical features were those described in the literature. Patient s were treated by corticosteroids combined with acetazolamide and CSF depletion in all cases. CSF derivation was performed in only 1 patient. Definitive blindne ss was noted in 2 patients at admission. A favorable course was noted in 8/10 ca ses, with regression of papilledema within approximately 1 month. Discussion. We suggest that the corticosteroid-acetazolamide combination can have a benefici al effect on papilledema in BIH. However, these results should be confirmed by a prospective, randomized, double blind controlled study. Introduction. Benign intracranial hypertension (BIH) or pseudotumor cerebri is diagnosed on the basis of Dandy’s criteria. BIH creates an emergency situati on because of the risk of lost vision. In this work, we studied retrospectively a series of 10 cases of BIH all meeting Dandy’s criteria. Our objective was to assess the benefit of the corticosteroid-acetazolamide combination on clinica l course, especially on papile dema. Methods. Eighty-four patients were hospita lized at the neurology department (H pital des Spéialitis, Rabat) over They were divided into three groups: forty cas es of cerebral thromophlebitis, 10 cases of BIH. In the remaining 34 cases, the investigations were insufficient, so that Dandy’s criteria could not be verifi ed We studied only the 10 cases presented with a diagnosis of BIH diagnosis co mplying with Dandy’s criteria. The patients underwent a physical examination, cerebral magnetic resonance imaging (MRI) if pos sible or CT scan with convention al angiography, and CSF examination with pressure measurement. We analyzed age, sex-ratio, clinical aspects and the outcome after treatment. The major criteri on of outcome was the regression of papilledema. Results. There were 9 women The clinical features were those described in the literature. Patient s were treated by corticosteroids combined with acetazolamide and CSF depletion in all cases. CSF A favorable course was noted in 8/10 ca ses, with regression of papilledema within approximately 1 month. Discussion. We suggest that the corticosteroid-acetazolamide combination However, these results should be be confirmed by a prospective, randomized, double blind controlled study.
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