Background

The proportion of children with recurrent signs and symptoms of intracranial hypertension after medication wean has been reported to be between 18% and 50%. Few studies have reported intracranial hypertension recurrence risk in children while adjusting for each individual's observed follow-up time after medication wean. In addition, the role of intracranial hypertension etiology on the risk of disease recurrence has not been widely studied.

Methods

The medical charts of patients with intracranial hypertension treated with intracranial pressure-lowering medication were analyzed retrospectively for disease recurrence. Baseline characteristics from diagnosis were recorded in addition to information regarding duration of therapy, medication wean, and recurrence. Survival analyses as well as Poisson regression models with time under observation as an offset were performed.

Results

One hundred and thirty-three patients were included in the study. The cumulative risk of intracranial hypertension recurrence increased rapidly within the first six months after medication wean and was 1.5% at one month, 9.5% at three months, and 20% at six months. This risk leveled off near 12 to 18 months.

Conclusions

While the cumulative risk of intracranial hypertension recurrence increases most dramatically within the first six months after medication wean, it does not appear to taper until 12 to 18 months. Given the possibility of delayed or asymptomatic recurrences, long-term follow-up is ideal, although patients can likely be seen less frequently after the first 12 to 18 months after medication wean.

中文翻译：

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颅内降压药物停药后颅内高压复发风险

背景

据报道，停药后出现颅内高压症状和体征的儿童比例在 18% 至 50% 之间。很少有研究报告儿童颅内高压复发风险，同时调整每个人在停药后观察到的随访时间。此外，颅内高压病因对疾病复发风险的作用尚未得到广泛研究。

方法

回顾性分析颅内高压患者经颅内降压药物治疗后疾病复发情况。除了有关治疗持续时间、停药和复发的信息外，还记录了诊断的基线特征。进行了生存分析和泊松回归模型，以观察时间为偏移量。

结果

一百三十三名患者被纳入研究。颅内高压复发的累积风险在停药后的前 6 个月内迅速增加，1 个月时为 1.5%，3 个月时为 9.5%，6 个月时为 20%。这种风险在 12 到 18 个月内趋于平稳。

结论

虽然颅内高压复发的累积风险在停药后的前六个月内增加最为显着，但似乎直到 12 至 18 个月才逐渐减少。考虑到延迟或无症状复发的可能性，长期随访是理想的，尽管在药物戒断后的前 12 至 18 个月后患者的就诊频率可能会降低。