While most headaches in children can be treated with over-the-counter pain medications or lifestyle changes, it is important to pay attention to their symptoms in case they herald something more serious.
Doctors at Nationwide Children’s Hospital are at the forefront of treating a disorder that causes headaches called pseudotumor cerebri. This disorder is characterized by chronically increased pressure inside the head in the absence of a brain tumor. The name of the condition derives from the similarity of its symptoms to those of a brain tumor. If left untreated, pseudotumor cerebri typically causes continued headaches and often leads to permanent visual loss in children.
“The diagnosis of pseudotumor cerebri in children has increased dramatically in recent years,” said E. Steve Roach, MD, Chief of Neurology and Vice-Chair of Pediatrics at Nationwide Children’s Hospital and professor of Pediatrics and Neurology at The Ohio State University College of Medicine. “While the exact prevalence of pseudotumor cerebri in children is unknown, researchers suspect that the rise in childhood obesity coupled with increased awareness of the condition has led to more diagnoses.”
Most patients who suffer from this disorder are overweight, but about a third of the children are not obese. Pseudotumor cerebri is typically suspected after a child with headaches is found to have optic nerve edema. The diagnosis is confirmed after a brain scan eliminates a tumor and after the pressure elevation is confirmed. Once the diagnosis is confirmed, the child’s visual function is closely monitored and any underlying risk factors are eliminated. While medications are typically administered to relieve the pressure, surgical procedures to lower the intracranial pressure or to prevent pressure damage of the optic nerve are prescribed as needed.
“Nationwide Children’s is leading the response to this trend with the development of a multidisciplinary clinic for the specialized diagnosis, treatment and on-going care of these unique children,” said David Rogers, MD, an ophthalmologist at Nationwide Children’s Hospital. “We encourage early referral of any child with optic nerve edema or other signs of pseudotumor cerebri.”
The physician team at Nationwide Children’s introduced the first pediatric Pseudotumor Cerebri Clinic in the United States that provides comprehensive care by an array of disciplines including child neurology, ophthalmology, nutrition and referrals as needed to pediatric neurosurgery and endocrinology. Currently, physicians at Nationwide Children’s are treating about 80 children with pseudotumor cerebri. The clinic, which officially launched in March 2010, is treating patients who have shown common symptoms like those of headaches and vision loss. The loss of vision can be rapid or insidious, and the severity of headaches or other symptoms does not reliably correlate with the risk of visual loss.
Nationwide Children’s supports research into the disorder in The Research Institute at Nationwide Children’s Hospital and The Ohio State University College of Medicine as an academic partner. The clinic is managed by board certified child neurologists and board certified pediatric ophthalmologists.