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Hi! I Have 10 Yo Daughter. She Is Normal BMI.

Posted on Mon, 28 Dec 2020

Question: Hi! I have 10 yo daughter. She is normal BMI. She had lumbur puncture done a few months ago. Her opening pressure in sitting position mildly sedated with midazolam was 31. She had blurry vision as well as sinus tachycardia and weakness in extremities. Doctors didn’t “seem” to find anything. A couple months later, she went completely blind on one eye and partially blind on the other in a matter of hours. No results again. A few days ago OCT of the eyes was done that showed mild papilledema consistent with ICH. I’m wondering if her opening pressure and clinical symptoms were supposed to warrant further investigation and prevent my daughter from becoming blind if treated on time? Is opening pressure of 31 considered abnormal?

Answered by Dr. Harshita (11 hours later)

Brief Answer:
The opening pressure is high

Detailed Answer:
Hey thanks for the question . Based on all your findings it does look like a case of IIH ( idiopathic intracranial hypertension ) its better to get a MRI brain . You have to consult a neurologist regarding the further course of action . intially medicines are given and if still it persists a shunt surgery is done . Hope it helps . Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Harshita (7 hours later)

MRI was done and it was normal. CT was normal too. However, second CT (4 months later) showed mild expansion of sella turcica. What is a normal CSF opening pressure for a 10 yo normal BMI in sitting position mildly sedated with midazolam?

Answered by Dr. Harshita (56 minutes later)

Brief Answer:
Yes i would consider it high as I think the cut off is at 25

Detailed Answer:
hey thanks for the follow up question. The dilatation and papilledema are conclusive IIH . A neurologist would help you in the treatment of the same . Hope it helps . Regards

Above answer was peer-reviewed by : Dr. Prasad