Journal of Pediatric Neurology 2015; 13(01): 035-037
DOI: 10.1055/s-0035-1555151
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Polycystic Ovarian Syndrome and Pseudotumor Cerebri Syndrome in Female Adolescents

Helena Ban Frangez
1   Department of Reproduction, University Medical Center, Ljubljana, Slovenia
,
Eda Vrtacnik Bokal
1   Department of Reproduction, University Medical Center, Ljubljana, Slovenia
,
Andrej Vogler
1   Department of Reproduction, University Medical Center, Ljubljana, Slovenia
,
Vesna Salamun
1   Department of Reproduction, University Medical Center, Ljubljana, Slovenia
,
Sara Korosec
1   Department of Reproduction, University Medical Center, Ljubljana, Slovenia
,
Barbara Pozlep
1   Department of Reproduction, University Medical Center, Ljubljana, Slovenia
,
Nina Jancar
1   Department of Reproduction, University Medical Center, Ljubljana, Slovenia
› Author Affiliations
Further Information

Publication History

22 December 2014

08 February 2015

Publication Date:
13 July 2015 (online)

Abstract

Pseudotumor cerebri syndrome (PTCS) is characterized by elevated intracranial pressure, normal cerebrospinal fluid (CSF) content, and the lack of any identifiable causative mass on imaging of the central nervous system. This syndrome is usually characterized by headache and double vision, and typically occurs in obese women during their reproductive years. The pathogenesis of PTCS is unknown, although various etiologic factors have been proposed as the likely cause, including changes in CSF dynamics due to metabolic-hormonal derangements and/or increased venous blood pressure in the brain due to transverse sinus stenosis. PTCS has been reported in association with several comorbidities, including polycystic ovarian syndrome (PCOS). The mechanism that leads to increased intracranial pressure and PTCS in females with PCOS awaits elucidation; however, PCOS is typically associated with hyperaldosteronism and the latter has been considered in recent years an important risk factor for PTCS, likely due to an aldosterone-mediated elevation of CSF pressure. Nevertheless, further studies remain to be done to elucidate fully the etiology of PTCS in female adolescents affected by PCOS.

 
  • References

  • 1 Durcan FJ, Corbett JJ, Wall M. The incidence of pseudotumor cerebri. Population studies in Iowa and Louisiana. Arch Neurol 1988; 45 (8) 875-877
  • 2 Radhakrishnan K, Thacker AK, Bohlaga NH, Maloo JC, Gerryo SE. Epidemiology of idiopathic intracranial hypertension: a prospective and case-control study. J Neurol Sci 1993; 116 (1) 18-28
  • 3 Rangwala LM, Liu GT. Pediatric idiopathic intracranial hypertension. Surv Ophthalmol 2007; 52 (6) 597-617
  • 4 Wall M. Idiopathic intracranial hypertension. Neurol Clin 2010; 28 (3) 593-617
  • 5 Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 2013; 81 (13) 1159-1165
  • 6 Paley GL, Sheldon CA, Burrows EK, Chilutti MR, Liu GT, McCormack SE. Overweight and obesity in pediatric secondary pseudotumor cerebri syndrome. Am J Ophthalmol 2015; 159 (2) 344-52.e1
  • 7 Salpietro V, Polizzi A, Di Rosa G , et al. Adrenal disorders and the paediatric brain: pathophysiological considerations and clinical implications. Int J Endocrinol 2014; 2014: 282489
  • 8 Brara SM, Koebnick C, Porter AH, Langer-Gould A. Pediatric idiopathic intracranial hypertension and extreme childhood obesity. J Pediatr 2012; 161 (4) 602-607
  • 9 Salpietro V, Chimenz R, Arrigo T, Ruggieri M. Pediatric idiopathic intracranial hypertension and extreme childhood obesity: a role for weight gain. J Pediatr 2013; 162 (5) 1084
  • 10 Andrews LE, Liu GT, Ko MW. Idiopathic intracranial hypertension and obesity. Horm Res Paediatr 2014; 81 (4) 217-225
  • 11 Huff AL, Hupp SL, Rothrock JF. Chronic daily headache with migrainous features due to papilledema-negative idiopathic intracranial hypertension. Cephalalgia 1996; 16 (6) 451-452
  • 12 Glueck CJ, Aregawi D, Goldenberg N, Golnik KC, Sieve L, Wang P. Idiopathic intracranial hypertension, polycystic-ovary syndrome, and thrombophilia. J Lab Clin Med 2005; 145 (2) 72-82
  • 13 Glueck CJ, Iyengar S, Goldenberg N, Smith LS, Wang P. Idiopathic intracranial hypertension: associations with coagulation disorders and polycystic-ovary syndrome. J Lab Clin Med 2003; 142 (1) 35-45
  • 14 Shin SH, Kim YM, Kim HY, Lee YJ, Nam SO. Idiopathic intracranial hypertension associated with polycystic ovarian syndrome. Pediatr Int 2014; 56 (3) 411-413
  • 15 Horn M, Geraci SA. Polycystic ovary syndrome in adolescents: (women's health series). South Med J 2013; 106 (10) 570-576
  • 16 Laganà AS, Pizzo A. Know your enemy: the rationale of using inositol in the treatment of polycystic ovary syndrome. Endocrinol Metab Synd 2013; 2: e121
  • 17 Caserta D, Adducchio G, Picchia S, Ralli E, Matteucci E, Moscarini M. Metabolic syndrome and polycystic ovary syndrome: an intriguing overlapping. Gynecol Endocrinol 2014; 30 (6) 397-402
  • 18 Laganà AS, Barbaro L, Pizzo A. Evaluation of ovarian function and metabolic factors in women affected by polycystic ovary syndrome after treatment with D-Chiro-Inositol. Arch Gynecol Obstet 2015; 291 (5) 1181-1186
  • 19 Bird ST, Hartzema AG, Brophy JM, Etminan M, Delaney JA. Risk of venous thromboembolism in women with polycystic ovary syndrome: a population-based matched cohort analysis. CMAJ 2013; 185 (2) E115-E120
  • 20 Nandi A, Chen Z, Patel R, Poretsky L. Polycystic ovary syndrome. Endocrinol Metab Clin North Am 2014; 43 (1) 123-147
  • 21 Pizzo A, Laganà AS, Barbaro L. Comparison between effects of myo-inositol and D-chiro-inositol on ovarian function and metabolic factors in women with PCOS. Gynecol Endocrinol 2014; 30 (3) 205-208
  • 22 González F, Rote NS, Minium J, Kirwan JP. Reactive oxygen species-induced oxidative stress in the development of insulin resistance and hyperandrogenism in polycystic ovary syndrome. J Clin Endocrinol Metab 2006; 91 (1) 336-340
  • 23 Chirico V, Lacquaniti A, Salpietro V , et al. High-mobility group box 1 (HMGB1) in childhood: from bench to bedside. Eur J Pediatr 2014; 173 (9) 1123-1136
  • 24 Chirico V, Cannavò S, Lacquaniti A , et al. Prolactin in obese children: a bridge between inflammation and metabolic-endocrine dysfunction. Clin Endocrinol (Oxf) 2013; 79 (4) 537-544
  • 25 Arrigo T, Chirico V, Salpietro V , et al. High-mobility group protein B1: a new biomarker of metabolic syndrome in obese children. Eur J Endocrinol 2013; 168 (4) 631-638
  • 26 Ehrhart-Bornstein M, Lamounier-Zepter V, Schraven A , et al. Human adipocytes secrete mineralocorticoid-releasing factors. Proc Natl Acad Sci U S A 2003; 100 (24) 14211-14216
  • 27 Salpietro V, Polizzi A, Bertè LF , et al. Idiopathic intracranial hypertension: a unifying neuroendocrine hypothesis through the adrenal-brain axis. Neuroendocrinol Lett 2012; 33 (6) 569-573
  • 28 McGeeney BE, Friedman DI. Pseudotumor cerebri pathophysiology. Headache 2014; 54 (3) 445-458
  • 29 Salpietro V, Ruggieri M. Pseudotumor cerebri pathophysiology: the likely role of aldosterone. Headache 2014; 54 (7) 1229
  • 30 Khan MU, Khalid H, Salpietro V, Weber KT. Idiopathic intracranial hypertension associated with either primary or secondary aldosteronism. Am J Med Sci 2013; 346 (3) 194-198
  • 31 Salpietro V, Ruggieri M, Sancetta F , et al. New insights on the relationship between pseudotumor cerebri and secondary hyperaldosteronism in children. J Hypertens 2012; 30 (3) 629-630
  • 32 Salpietro V, Mankad K, Kinali M , et al. Pediatric idiopathic intracranial hypertension and the underlying endocrine-metabolic dysfunction: a pilot study. J Pediatr Endocrinol Metab 2014; 27 (1-2) 107-115
  • 33 Sheldon CA, Kwon YJ, Liu GT, McCormack SE. An integrated mechanism of pediatric pseudotumor cerebri syndrome: evidence of bioenergetic and hormonal regulation of cerebrospinal fluid dynamics. Pediatr Res 2015; 77 (2) 282-289
  • 34 Kesler A, Kliper E, Shenkerman G, Stern N. Idiopathic intracranial hypertension is associated with lower body adiposity. Ophthalmology 2010; 117 (1) 169-174
  • 35 Sheehan JP. Hormone replacement treatment and benign intracranial hypertension. Br Med J (Clin Res Ed) 1982; 284 (6330) 1675-1676