Pseudotumor cerebri syndrome in a child with Alagille syndrome: intracranial pressure dynamics and treatment outcome after ventriculoperitoneal shunting.


Journal

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
ISSN: 1433-0350
Titre abrégé: Childs Nerv Syst
Pays: Germany
ID NLM: 8503227

Informations de publication

Date de publication:
09 2021
Historique:
received: 09 03 2020
accepted: 14 01 2021
pubmed: 9 2 2021
medline: 16 9 2021
entrez: 8 2 2021
Statut: ppublish

Résumé

Alagille syndrome (AS) is a rare multisystem disease of the liver, heart, eyes, face, skeleton, kidneys, and vascular system. The occurrence of pseudotumor cerebri syndrome (PTCS) in patients with AS has been reported only exceptionally. Owning to its rarity and a mostly atypical presentation, the diagnosis and natural history of affected patients remain uncertain. We report an atypical case of PTCS in a 4-year-old boy with a known history of AS who presented with bilateral papilledema (PE) on a routine ophthalmological examination. Visual findings deteriorated after treatment with acetazolamide. Continuous intracranial pressure (ICP) monitoring was then utilized to investigate ICP dynamics. Successful treatment with resolution of PE was achieved after ventriculoperitoneal shunting but relapsed due to growth-related dislocation of the ventricular catheter. This report brings new insights into the ICP dynamics and the resulting treatment in this possibly underdiagnosed subgroup of PTCS patients. It also demonstrates that ventriculoperitoneal shunting can provide long-term improvement of symptoms for more than 10 years.

Identifiants

pubmed: 33555437
doi: 10.1007/s00381-021-05043-9
pii: 10.1007/s00381-021-05043-9
pmc: PMC8423640
doi:

Types de publication

Case Reports Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2899-2904

Informations de copyright

© 2021. The Author(s).

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Auteurs

Manolis Polemikos (M)

Department of Neurosurgery, Hannover Medical School, MHH, Carl-Neuberg-Str. 1, DE-30625, Hannover, Germany. polemikos.manolis@mh-hannover.de.

Elvis J Hermann (EJ)

Department of Neurosurgery, Hannover Medical School, MHH, Carl-Neuberg-Str. 1, DE-30625, Hannover, Germany.

Hans E Heissler (HE)

Department of Neurosurgery, Hannover Medical School, MHH, Carl-Neuberg-Str. 1, DE-30625, Hannover, Germany.

Hans Hartmann (H)

Clinic for Paediatric Nephrology, Hepatology and Metabolic Disorders, Hannover Medical School, Hannover, Germany.

Joachim K Krauss (JK)

Department of Neurosurgery, Hannover Medical School, MHH, Carl-Neuberg-Str. 1, DE-30625, Hannover, Germany.

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