儿童的良性颅内高压(BIH)被认为是无脑积水或颅内肿块的颅内压升高。它在成年人中表现不同,对性别或体重没有明显偏好。头痛,乳头水肿,并可能伴有视野缺损的第六神经麻痹是该综合征的典型症状。维生素A毒性是BIH的罕见原因。我们报告了一个以前健康的13岁女孩,表现为畏光,额头头痛,和呕吐。她有通过眼底镜检查发现的双侧乳头水肿。磁共振成像和脑部CT均正常。入院时,腰椎穿刺(LP)显示开放压力为26cmH2O,脑脊液(CSF)分析正常。BIH的诊断成立,开始用乙酰唑胺治疗,具有良好的临床效果。定期的眼睛评估显示乳头水肿消退。血清维生素A水平升高是唯一的阳性发现。两周内,病人出院,没有任何症状。这项研究旨在引起临床医生的注意,在接受正常神经放射学检查的儿童中,在乳头水肿和动眼问题的背景下评估维生素A毒性的重要性。
Benign intracranial hypertension (BIH) in children is recognized as elevated intracranial pressure without hydrocephalus or intracranial mass. It manifests differently in adults, with no apparent predilection for sex or weight. Headache, papilledema, and possibly sixth nerve palsy with visual field defects are the typical symptoms of this syndrome. Vitamin A toxicity is a rare cause of BIH. We report the
case of a previously healthy 13-year-old girl presenting with photophobia, a frontal headache, and vomiting. She had bilateral papilledema discovered by fundoscopy. Both magnetic resonance imaging and brain CT were normal. At admission, a lumbar puncture (LP) revealed an opening pressure of 26 cm H2O with normal cerebrospinal fluid (CSF) analysis. The diagnosis of BIH was established, and treatment with acetazolamide was started, with good clinical results. Regular eye evaluations showed a regression of papilledema. Elevated serum vitamin A levels were the only positive findings. Within two weeks, the patient was discharged without any symptoms. This study aims to attract the attention of clinicians to the importance of evaluating vitamin A toxicity in the context of papilledema and oculomotor problems in a child who has undergone normal neuroradiological investigations.