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Cranial morcellation decompression for refractory idiopathic intracranial hypertension in children

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Abstract

Background

Primary idiopathic intracranial hypertension (PIIH) in children is rare and has a poorly understood pathophysiology. It is characterized by raised intracranial pressure (ICP) in the absence of an identified brain lesion. Diagnosis is usually confirmed by the measurement of a high cerebrospinal fluid (CSF) opening pressure and exclusion of secondary causes of intracranial hypertension. Refractory PIIH may lead to severe visual impairment. The purpose of this study was to evaluate a cranial morcellation decompression (CMD) technique as a new surgical alternative to stabilize intracranial pressure in PIIH.

Materials and methods

A literature review was carried out, disclosing only 7 pediatric cases of PIIH treated with surgical skull expansion. In addition, we describe here one case of our own experience treated by CMD.

Conclusions

CMD surgery is a safe and effective option to control refractory PIIH in selected patients.

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, Brazil

    Matheus Fernando Manzolli Ballestero, Thiago Lyrio Teixeira, Lucas Pires Augusto, Stephanie Naomi Funo de Souza, Marcelo Volpon Santos & Ricardo Santos de Oliveira

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  1. Matheus Fernando Manzolli Ballestero
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Correspondence to Matheus Fernando Manzolli Ballestero.

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Ballestero, M.F.M., Teixeira, T.L., Augusto, L.P. et al. Cranial morcellation decompression for refractory idiopathic intracranial hypertension in children. Childs Nerv Syst 34, 1111–1117 (2018). https://doi.org/10.1007/s00381-018-3766-1

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