TY - T1的暴发性特发性颅内高血压JF -神经学乔-神经病学SP - 229 LP - 232做wnl.0000251312.19首页452 10.1212/01.。ec六世- 68 - 3盟Madhav Thambisetty AU -帕特里克·j·拉文非盟-南希·j·纽曼AU -瓦莱丽Biousse Y1 - 2007/01/16 UR - //www.ez-admanager.com/content/68/3/229.abstr首页act N2 -目的:描述急性的发病率和特点以及快速进行性视力丧失在特发性颅内高血压(IIH)。方法:我们回顾了所有颅内高压症患者的医疗记录在两个机构。“暴发性颅内高压症”被定义为急性发作的症状和体征颅内高血压(少于4周之间出现最初症状和严重的视力丧失),快速恶化的视觉损失超过几天,和正常的大脑核磁共振造影术先生(或CT静脉造影照片)。结果:16例暴发性颅内高压症”包括(16名女性,平均年龄23.8岁[14到39年])。都是肥胖。一个病人有缺铁性贫血,四个系统性高血压,不知道睡眠呼吸暂停综合症。急性或亚急性头痛、恶心和呕吐,视力丧失,在所有的病人。第一腰椎穿刺诊断显示执行意味着CSF开启压力的54.1厘米水(29到60厘米水)。除了最初的腰椎穿刺,治疗包括乙酰唑胺(1到2 g /天)在所有的病人,和四甲基强的松龙在四个病人。 Repeat lumbar punctures were performed in 11 of the 16 patients. Surgical treatment (optic nerve sheath fenestration in five cases, lumboperitoneal CSF shunting procedure in nine cases, and ventriculoperitoneal shunting procedure in two cases) was performed because of ongoing visual loss in all cases. The median delay between evaluation in neuro-ophthalmology and surgery was 3 days (range a few hours to 37 days). All patients reported dramatic improvement of headaches and vomiting following surgery. Visual function improved in 14 cases, although 8 patients (50%) remained legally blind. Visual fields remained severely altered in all cases. Conclusion: Severe and rapidly progressive visual loss suggests “fulminant idiopathic intracranial hypertension” and should prompt aggressive management. Urgent surgery may be required in these patients, and temporizing measures such as repeat lumbar punctures, lumbar drainage, and IV steroids considered. ER -