Idiopathic intracranial hypertension (IIH) is characterized by an elevated intracranial pressure of unclear aetiology. It particularly occurs in overweight, young women, but can also affect children. As a therapy weight loss, repeated spinal taps, treatment with acetazolamide or ventricular-peritoneal or lumbo-peritoneal shunts are used. The aim is to prevent neurological damage especially to the optic nerve. Within 15 years 16 patients (11 male) were treated. Diagnosis was made according to the diagnostic criteria of Friedmann und Jacobson (2002) or to the modified Dandy-criteria. Initial symptoms were headache (69%) and impaired vision (31%), in infants also a progressive macrocephaly. The mean pressure at the first spinal tap was 42cm H2O. Papilledema was found in 75% of the patients.
As an accompanying factor adipositas was noted in 9 cases, one case had a severe brain injury and a second one had a sinus venous thrombosis before developing an IIH. All the other cases were idiopathic.
Age distribution showed two peaks, one within the first two years of life, the second at the age of 10–12 years.
Therapy was initiated with repeated spinal taps (successful in one case), followed by a therapy with Acetazolamide (successful in 8 cases). If unsuccessful, a shunt procedure was performed (ventriculoperitoneal in 2 cases and lumboperitoneal in 5 cases).
Conclusion: It is possible for children to develop IIH. IIH seems to be accompanied by adipositas in prepuberty, but not in young children.
Repeated spinal taps were not effective as treatment. Medication with Acetazolamide resolved papilledema in 50%. In case of failure shunt procedures proved to be effective.
