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Optic neuropathy associated with idiopathic intracranial hypertension. Diagnostic and treatment guide

Optic neuropathy associated with idiopathic intracranial hypertension. Diagnostic and treatment guide

Name: Optic neuropathy associated with idiopathic intracranial hypertension. Diagnostic and treatment guide
Brand: Editura Universitară
SKU: 9786062819323
Price: 52.86 RON
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52,86 Lei

Publisher: Editura Universitară

Author: Corina Merticariu

Edition: I

Pages: 112

Publisher year: 2025

ISBN: 978-606-28-1932-3

DOI: https://doi.org/10.5682/9786062819323

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FOREWORD/5
AUTHOR'S NOTE/7
INTRODUCTION/11
I. INTRACRANIAL HYPERTENSION/15
1.1. Nomenclature and epidemiology/15
1.2. Pathophysiology/15
1.3. Clinic/17
1.4. Treatment/17
II. IDIOPATHIC INTRACRANIAL HYPERTENSION/19
2.1 Idiopathic intracranial hypertension in adults /19
2.1.1.     History and nomenclature/19
2.1.2.     Epidemiology and risk factors/19
2.1.3.     Pathophysiology/22
2.1.4.     Clinic/26
2.1.5.     Diagnosis/29
2.1.6.     Monitoring/30
2.1.7.     Differential diagnosis/33
2.1.8.     Management/33
2.1.9.     Particular situations/37
2.2. Idiopathic HIC in children and adolescents /38
2.2.1.     History and current nomenclature/38
2.2.2.     Epidemiology and risk factors/39
2.2.3.     Pathophysiology/41
2.2.4.     Clinical presentation/42
2.2.5.     Monitoring/44
2.2.6.     Treatment/46
III. OPTIC NEUROPATHY FROM IDIOPATHIC HIC/49
3.1.        Evaluation of visual impairment in idiopathic HIC/49
3.2.        Histopathological changes in the visual pathway in idiopathic HIC /51
3.3.        Adoration of papillary edema/52
3.3.1.     The mechanism of appearance of papillary edema/52
3.3.2.     Evaluation of papillary edema and optic neuropathy/54
3.4.        Peculiarities of the assessment of optic neuropathy in children/62
IV. A PRACTICAL PERSPECTIVE IN THE RESEARCH OF OPTIC NEUROPATHY FROM IDIOPATHIC HIC/65
V. BIBLIOGRAPHY/92
V. LIST OF ABBREVIATIONS/108
VI.          LIST OF TABLES, FIGURES, CASSETTES, PHOTOS/110

The decision to study this topic and write this book was born from a case that marked me deeply: a pediatric patient with symptoms suggestive of intracranial hypertension, in whom, after excluding secondary causes, the diagnosis of intracranial hypertension (ICH) was established idiopathic. Although the applied treatment was adequate, and the monitoring of the patient was carried out according to the best practices, the evolution of the disease was unpredictable, marked by multiple recurrences. However, a remarkable aspect was the preservation of intact visual function – a possible result due to the excellent collaboration with the patient's parents and the attending neuropediatrician. This experience showed me the importance of continuous and rigorous monitoring, supported by family compliance and well-calibrated therapeutic interventions.

Practically, the peculiarity of the case consisted in the detailed tomographic follow-up, which allowed the early identification of structural variations in the appearance of the optic nerve, even before the appearance of clinical optic edema. This level of precision gave me the opportunity to adjust the treatment in real time, preventing severe complications (florid changes of edema.).
As a pediatric ophthalmologist, I cannot help but think about the long-term prognosis of this disease and its impact on the lives of patients and their families. It is essential to analyze both the functional and the psychological consequences of the condition. Because of the recurrences and the complexity of the symptoms, the life of these patients can be deeply affected. On the one hand, suffering is caused by direct organic manifestations - refractory headache, vision impairment and other complications. On the other hand, the psychological impact is considerable, generated by the uncertainty of a disease with chronic potential and unknown triggering factors, but also by the fear of comorbidities and relapses. All this can severely limit the social, professional and personal life of these young people. However, an approach based on in-depth knowledge of the disease and appropriate treatments can prevent many of these consequences. Patient and family education, along with close collaboration between doctors, can transform a reserved prognosis into a life closer to normality.
Identifying the risk factors and clinical changes characteristic of idiopathic intracranial hypertension is an essential step in the deep understanding of this disease. The improvement of diagnostic and treatment methods, especially regarding optic neuropathy associated with idiopathic HIC, can contribute to the development of a more efficient diagnostic protocol. This, in turn, could allow a treatment better adapted to the patients' needs, significantly improving the long-term prognosis.
It is imperative that this condition be known, approached responsibly and treated integratedly, within an effective multidisciplinary collaboration system. In the absence of sufficient local resources, telemedicine can offer a valuable alternative for patient management.
A good knowledge and a rigorous approach to the disease can make the difference between an individual who actively participates in society and a person marked by severe disabilities whose life is strongly dependent on external support. Through an adequate and early intervention, the burden of this condition on patients, families and society in general can be considerably reduced.

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