Spectrum of benign intracranial hypertension in children and adolescents

Childs Nerv Syst. 1985;1(2):81-6. doi: 10.1007/BF00706687.


A review of the most recent 23 cases of benign intracranial hypertension (BIH), admitted to the War Memorial Children's Hospital in London, Ontario, provided a compendium of the clinical manifestations of this disorder in children and adolescents. Although CT scanning lets one feel more secure in making such a diagnosis, pitfalls still exist. The sex ratio was 11 males to 12 females. Age groupings were: 0-6 years (2 patients); 7-12 years (10); 13-17 years (11). No postviral etiologies were encountered in patients more than 13 years of age. In only 6 cases could no definite etiology be established. Of great importance was the recognition of the condition in 12 patients who did not have papilledema. Elevated intracranial pressure was proven in 8 of these by lumbar CSF pressure monitoring, in 1 by lumbar punctures and in 1 infant with split cranial sutures. Absence of papilledema was confirmed by ophthalmological examination. Transient visual obscurations were very common in this group. In 6 patients, persistent signs and symptoms in spite of vigorous drug therapy prompted lumboperitoneal shunting, with immediate relief of symptoms in all. In only 1 case has the diagnosis of BIH proven to be in error. A warning leak from an aneurysm caused papilledema and headache, and a normal CT scan supported the diagnosis until the patient had a major hemorrhage weeks later. BIH has a variety of causes in children and adolescents, and papilledema is not a prerequisite for diagnosis.

MeSH terms

  • Acetazolamide / therapeutic use
  • Adolescent
  • Anti-Bacterial Agents / adverse effects
  • Brain Concussion / complications
  • Cerebrospinal Fluid Shunts
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Headache / etiology
  • Humans
  • Infant
  • Intracranial Aneurysm / complications
  • Intracranial Pressure / drug effects
  • Male
  • Meningitis, Viral / complications
  • Papilledema / etiology
  • Pseudotumor Cerebri / etiology*
  • Pseudotumor Cerebri / surgery
  • Spinal Puncture
  • Subarachnoid Hemorrhage / complications
  • Vision Disorders / etiology


  • Anti-Bacterial Agents
  • Acetazolamide