ISSN: 1300-0365
Dil: Türkçe
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İdiyopatik İntrakranial Hipertansiyon
Tongalp H. TEZEL*, İlhan GÜNALP**, Gülgün TEZEL*
*Uz. Dr. 2.Göz Kliniği Başasistanı, Ankara Numune Hast.**Prof.Dr. Göz Hast.ABD. Ankara Ü.T.F
IDIOPA THIC INTRACRANIAL HYPERTENSION
Idiopathic intracranial hypertension is characterized by increased intracranial pressure that is not secondary to space occupying
lesion, accompanied by normal or small ventricles, normal cerebrospinal fluid composition and no focal neurologic signs.
Although it is not a common entity, it deserves a special attention since it can cause serious visual loss by either nerve fiber
bundle defects or macular complications. In order to put forward the clinical features and predisposing factors of this syndrome,
as well as to investigate the relative effectiveness of visual field and nerve fiber analysis in detecting the functional loss, the
demographic, antrophometric and clinical data of 16 patiens diagnosed as idiopathic intracranial hypertension between 1985-
1991 were reviewed. Obesity and related disturbances, such as systemic arterial hypertension, menstruel cyclus irregularities and
hypercholesterolemia, followed by, pregnancy, vitamin-A intake, congestive heart failure and anemia appeared to be the major
predisposing factors. However it was only the obesity (p<0.05) and hypercholesterolemia (p<0.01) which was proved to be statistically
significant. The female/male ratio was 15/1 and 66,7% of the female cases were gathered in the 20-44 age group. Visual
field analysis and nerve fiber layer photography revealed severe defects in 78,57% and 45% of the examined cases, respectively.
On the contrary, 77,78% of the cases, who were diagnosed to have nerve fiber bundle defects, had normal visual acuties. Superior
temporal nerve fiber loss, which was found to be 3,5 times more frequent than the loss in the inferior temporal area, marked
this region as the most sensitive zone for the irreversible axonal damage. Statistical analysis revealed no correlation between the
defects disclosed by visual tied and nerve fiber layer photography (khi2 = 0.11 p>0.05; phi « 0.03). This signified the complementary
role of the both techniques for the detection of early functional loss. Under the light of such findings, the importance of
detecting the early functional loss in order to avoid irreversible damage by macular complications and axonal oss is discussed
and the probable value of nerve fiber layer analysis is stressed.Keywords: Idiopathic intracranial hypertension, Obesity, Pseudotumor cerebri, Nerve fiber layer analysis
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