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3year old with increased intracranial pressuer

Starting last December my three year-old had orbital cellulitis and was prescribed a Z-Pak. Not two weeks later she walked out of her room saying "two daddies, two milk cups".  The episode lasted until the next morning where I eye was turned inward and she saw double. Only findings on CAT scan and MRI were mild sinus infections, so her Ophthalmologist diagnosed it as post viral 6th nerve palsy since she had had a cold.  It happened several more times where one or both eyes would turn inward, even her eyes would look normal and she would tell us she was seeing two and it would last for 5-15 minutes and the last time was in March, then they started happening again in October this year, which her doctor didn't think it would recur.  Her eye exams are still completely normal. So her eye doctor ordered spinal tap, done on Tuesday and it showed borderline elevated pressure.  We are awaiting bloodwork results as well but her ophthalmologist and neurophthalmologist are sure they won't show infection because she is otherwise the picture of health. And she doesn't have any sign of a cold right now and it has happened four times in the last two weeks.  I am so freightened for my little girl.  What could be causing the elevated pressure or her double vision?
3 Responses
Avatar universal
Hi Katiesmom,
How is your child now? Raised Intracranial tension could be due some obstruction in CSF flow causing other symptoms like double vision. 6th nerve palsy is common in raised ICT as it has longest course intra-cranially. CT scan would help in diagnosing the condition.
Avatar universal
Hi,
More of CSF producti on and less of absorption is the basic cause of raised ICP.Or an obstruction to the outlet flow of CSF can be another cause..
The causes and associated symptoms  of raised ICP may vary.The reasons like:
Causes of increased intracranial pressure can be classified by the mechanism in which ICP is increased:
mass effect such as brain tumor, infarction with edema, contusions, subdural or epidural hematoma, or abscess all tend to deform the adjacent brain.
generalized brain swelling can occur in ischemic-anoxia states, acute liver failure, hypertensive encephalopathy, pseudotumor cerebri, hypercarbia, and Reye hepatocerebral syndrome. These conditions tend to decrease the cerebral perfusion pressure but with minimal tissue shifts.
increase in venous pressure can be due to venous sinus thrombosis, heart failure, or obstruction of superior mediastinal or jugular veins.
obstruction to CSF flow and/or absorption can occur in hydrocephalus (blockage in ventricles or subarachnoid space at base of brain, e.g., by Arnold-Chiari malformation), extensive meningeal disease (e.g., infectious, carcinomatous, granulomatous, or hemorrhagic), or obstruction in cerebral convexities and superior sagittal sinus (decreased absorption)
increased CSF production can occur in meningitis, subarachnoid hemorrhage, or choroid plexus tumor.
A second opinion from a neuroopthalmologist is vital.Do not hesitate to consult a child psychiatrist,it could as well be a psychological problem.
Goodluck

Avatar universal
my baby  4yeares old sudenly  he develope headach and early morenning vomitting  and i consult many doctors  since one mounth , ido all investigation  {blood-LFT -RFT }and  CTA SCAN  ,MRI MRIV .
All reveal  no pathology only  maxillary  sinus  infection.
apthalmogical  exam  reneal  papillary oedema  in both  eyes  grad 2-3
lumer punctuer  normal csf   .
HELP MY BABY AND  WHAT SHELL IDO
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