Shannon J Beres1, Claire A Sheldon2, Chantal J Boisvert3, Christina L Szperka4, Grace L Paley5, Evanette K Burrows6, Marianne R Chilutti6, Geraldine W Liu4, Shana E McCormack7, Grant T Liu8. 1. Departments of Neurology and Ophthalmology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Division of Ophthalmology, Neuro-ophthalmology Service, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Electronic address: sberes@stanford.edu. 2. Division of Ophthalmology, Neuro-ophthalmology Service, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada. 3. Division of Ophthalmology, Rady Children's Hospital San Diego, San Diego, California; Department of Ophthalmology, Gavin Herbert Eye Institute, University of California Irvine, Irvine, California. 4. Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 5. Departments of Neurology and Ophthalmology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. 6. Center for Biomedical Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 7. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 8. Departments of Neurology and Ophthalmology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Division of Ophthalmology, Neuro-ophthalmology Service, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Abstract
BACKGROUND: The purpose of this study was to determine the prognostic utility of closing pressure and volume of cerebrospinal fluid removed with respect to papilledema resolution and headache improvement in pediatric pseudotumor cerebri syndrome. METHODS: This is a retrospective observational study of 93 children with definite pseudotumor cerebri syndrome. The primary outcome measure was time to resolution of papilledema, and the secondary outcome measure was time to resolution of headache. RESULTS: There were no significant differences in gender, age, or body mass index z score observed between subjects with (N = 35) and without (N = 58) documented closing pressure. The median time to resolution of papilledema was not statistically different between children above or equal to and those below the median closing pressure (170 mm of cerebrospinal fluid, n = 31, P = 0.391) or the volume of median cerebrospinal fluid removed (16 mL, n = 19, P = 0.155). There was no statistically significant difference detected in days of headache between the children with opening pressure above and equal to the median (400 mm of cerebrospinal fluid) and the children with opening pressure below the median (n = 44, P = 0.634). CONCLUSIONS: No significant association between closing pressure, amount of cerebrospinal fluid removed, and time to resolution of papilledema due to pseudotumor cerebri syndrome was detected. The diagnostic and therapeutic purposes of either measuring the closing pressure or maximizing the volume of cerebrospinal fluid removed were not evident in these analyses.
BACKGROUND: The purpose of this study was to determine the prognostic utility of closing pressure and volume of cerebrospinal fluid removed with respect to papilledema resolution and headache improvement in pediatric pseudotumor cerebri syndrome. METHODS: This is a retrospective observational study of 93 children with definite pseudotumor cerebri syndrome. The primary outcome measure was time to resolution of papilledema, and the secondary outcome measure was time to resolution of headache. RESULTS: There were no significant differences in gender, age, or body mass index z score observed between subjects with (N = 35) and without (N = 58) documented closing pressure. The median time to resolution of papilledema was not statistically different between children above or equal to and those below the median closing pressure (170 mm of cerebrospinal fluid, n = 31, P = 0.391) or the volume of median cerebrospinal fluid removed (16 mL, n = 19, P = 0.155). There was no statistically significant difference detected in days of headache between the children with opening pressure above and equal to the median (400 mm of cerebrospinal fluid) and the children with opening pressure below the median (n = 44, P = 0.634). CONCLUSIONS: No significant association between closing pressure, amount of cerebrospinal fluid removed, and time to resolution of papilledema due to pseudotumor cerebri syndrome was detected. The diagnostic and therapeutic purposes of either measuring the closing pressure or maximizing the volume of cerebrospinal fluid removed were not evident in these analyses.
Authors: Michael Wall; Mark J Kupersmith; Karl D Kieburtz; James J Corbett; Steven E Feldon; Deborah I Friedman; David M Katz; John L Keltner; Eleanor B Schron; Michael P McDermott Journal: JAMA Neurol Date: 2014-06 Impact factor: 18.302
Authors: Robert A Avery; Samir S Shah; Daniel J Licht; Jeffrey A Seiden; Jimmy W Huh; Jan Boswinkel; Michael D Ruppe; Amber Chew; Rakesh D Mistry; Grant T Liu Journal: N Engl J Med Date: 2010-08-26 Impact factor: 91.245
Authors: Grace L Paley; Claire A Sheldon; Evanette K Burrows; Marianne R Chilutti; Grant T Liu; Shana E McCormack Journal: Am J Ophthalmol Date: 2014-11-07 Impact factor: 5.258
Authors: R J Kuczmarski; C L Ogden; L M Grummer-Strawn; K M Flegal; S S Guo; R Wei; Z Mei; L R Curtin; A F Roche; C L Johnson Journal: Adv Data Date: 2000-06-08