Endocrine Abstracts

Introduction: Pediatric intracranial hypertension (PIH) refers to increased pressure within the skull in children. While it is less common than in adults, hormonal factors can play a role in certain cases. Changes in hormone levels during puberty, particularly in girls, may contribute to this condition. This form is sometimes referred to as Idiopathic Intracranial Hypertension of Adolescence. We report a case of bilateral papilledema revealing idiopathic intracranial hypertension related to puberty

Observation: A 13-year-old patient, with no medical history, presented with complains of headache and diplopia for 3 days. The ophthalmological examination found visual acuity at 10/10 in both eyes, left VI nerve palsy, and bilateral papilledema. Goldman visual field testing revealed an enlargement of the blind spot in both eyes. Body mass index, brain magnetic resonance imaging, and laboratory tests including endocrine assessment were normal. Lumbar puncture showed an intracranial pressure of 50 mmHg. The diagnosis of idiopathic intracranial hypertension related to puberty was established. The patient was treated with acetazolamide and underwent depletive lumbar puncture. Outcome was favorable with complete regression of headaches, oculomotor disorders and normalization of intracranial pressure. After 5 years of follow-up, the patient remained stable without any recurrence

Conclusion: PIH is a rare condition, sometimes leading to severe visual involvement. The pathogenic mechanisms of this condition remain poorly understood. The association between PIH and puberty has been demonstrated. Indeed, puberty is characterized by an increase in growth hormone (GH) levels that crosses the blood-brain barrier and enhances cerebrospinal fluid production by the choroid plexus.