{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:52:18Z","timestamp":1760403138152,"version":"build-2065373602"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004375","name":"Tel Aviv University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Pseudotumor cerebri (PTC) is a relatively common cause of headaches in children. In order to exclude secondary causes, an extensive laboratory workup is generally recommended. This assessment causes blood loss, discomfort and a financial burden. To our knowledge, the diagnostic significance of such workup is unclear. We aimed to evaluate the clinical yield of PTC laboratory workup in a pediatric tertiary medical center<jats:bold>.\u00a0<\/jats:bold>This is a retrospective study in a tertiary pediatric hospital. Included were children hospitalized between 2010\u20132020 with new diagnosis of definite PTC, as confirmed by a certified pediatrician and ophthalmologist. Abnormal results were reviewed by two pediatricians for clinical significance. 75 children (58.7% girls, mean age 10.9\u2009\u00b1\u20094.25 years) with PTC were included. Secondary known causes for PTC were found in 20%, and 28% had other pre-existing medical conditions. Mean BMI was 24.53\u2009\u00b1\u20098.65 kg\/m<jats:sup>2<\/jats:sup>. Vitamin D insufficiency (&lt;\u200950 nmol\/L) was diagnosed in 68%, with over half with deficiency (less than 30 nmol\/L). Other than being overweight, the most common identifiable etiologies of PTC were drug-related. No additional secondary cases were diagnosed due to the extended work-up.<\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusion<\/jats:italic>: Our findings suggest that most PTC etiologies can be identified through medical history and physical examination, which may imply that an extensive laboratory work-up, except for vitamin D levels, may not be routinely required.<\/jats:p>\n          <jats:p>\n            <jats:table-wrap>\n              <jats:table>\n                <jats:tbody>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:bold>What is known:<\/jats:bold>\u2022 <jats:italic>An extensive laboratory workup is routinely recommended to exclude secondary PTC.<\/jats:italic>\u2022 <jats:italic>The clinical utility of PTC workup has not been assessed.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:bold>What is new:<\/jats:bold>\u2022 <jats:italic>A comprehensive medical history and physical examination probably suffices to diagnose secondary PTC.<\/jats:italic>\u2022 <jats:italic>An extensive laboratory work-up, except for vitamin D levels, may not be routinely required.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                <\/jats:tbody>\n              <\/jats:table>\n            <\/jats:table-wrap>\n          <\/jats:p>","DOI":"10.1007\/s00431-025-06389-x","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T06:04:07Z","timestamp":1757916247000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Etiological workup of pseudotumor cerebri in pediatric patients\u2014is it really necessary?"],"prefix":"10.1007","volume":"184","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1257-0062","authenticated-orcid":false,"given":"Lotem","family":"Goldberg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gad","family":"Dotan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Shirman Erel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hila","family":"Weisblum Neuman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keren","family":"Smuel Zilberberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Kadishevich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yehonatan","family":"Pasternak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Idan","family":"Goldberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoel","family":"Levinsky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dror","family":"Kraus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oded","family":"Scheuerman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"issue":"8","key":"6389_CR1","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1007\/s11916-019-0795-8","volume":"23","author":"R Barmherzig","year":"2019","unstructured":"Barmherzig R, Szperka CL (2019Jul 10) Pseudotumor Cerebri Syndrome in Children. Curr Pain Headache Rep 23(8):58. https:\/\/doi.org\/10.1007\/s11916-019-0795-8","journal-title":"Curr Pain Headache Rep"},{"key":"6389_CR2","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1016\/j.braindev.2022.03.006","volume":"44","author":"A Masri","year":"2022","unstructured":"Masri A, Al Jaberi M, Shihadat R, Rayyan A, AlMasri M, Abuna\u2019meh L et al (2022) Pseudotumor cerebri syndrome in children: Clinical characteristic and re-classification. Brain Dev 44:446\u2013453. https:\/\/doi.org\/10.1016\/j.braindev.2022.03.006","journal-title":"Brain Dev"},{"key":"6389_CR3","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s11910-018-0839-1","volume":"18","author":"JG Burkett","year":"2018","unstructured":"Burkett JG, Ailani J (2018) An Up to Date Review of Pseudotumor Cerebri Syndrome. Curr Neurol Neurosci Rep 18:33. https:\/\/doi.org\/10.1007\/s11910-018-0839-1","journal-title":"Curr Neurol Neurosci Rep"},{"key":"6389_CR4","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1097\/WCO.0000000000000273","volume":"29","author":"C Hainline","year":"2016","unstructured":"Hainline C, Rucker JC, Balcer LJ (2016) Current concepts in pseudotumor cerebri. Curr Opin Neurol 29:84\u201393. https:\/\/doi.org\/10.1097\/WCO.0000000000000273","journal-title":"Curr Opin Neurol"},{"key":"6389_CR5","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1212\/01.wnl.0000029570.69134.1b","volume":"59","author":"DI Friedman","year":"2002","unstructured":"Friedman DI, Jacobson DM (2002) Diagnostic criteria for idiopathic intracranial hypertension. Neurology 59:1492\u20131495. https:\/\/doi.org\/10.1212\/01.wnl.0000029570.69134.1b","journal-title":"Neurology"},{"key":"6389_CR6","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1136\/archdischild-2016-312238","volume":"102","author":"YY Matthews","year":"2017","unstructured":"Matthews YY, Dean F, Lim MJ, Mclachlan K, Rigby AS, Solanki GA et al (2017) Pseudotumor cerebri syndrome in childhood: incidence, clinical profile and risk factors in a national prospective population-based cohort study. Arch Dis Child 102:715\u2013721. https:\/\/doi.org\/10.1136\/archdischild-2016-312238","journal-title":"Arch Dis Child"},{"key":"6389_CR7","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1016\/j.ncl.2024.02.001","volume":"42","author":"DI Friedman","year":"2024","unstructured":"Friedman DI (2024) The Pseudotumor Cerebri Syndrome. Neurol Clin 42:433\u2013471. https:\/\/doi.org\/10.1016\/j.ncl.2024.02.001","journal-title":"Neurol Clin"},{"key":"6389_CR8","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1111\/ene.12442","volume":"21","author":"A Kesler","year":"2014","unstructured":"Kesler A, Stolovic N, Bluednikov Y, Shohat T (2014) The incidence of idiopathic intracranial hypertension in Israel from 2005 to 2007: results of a nationwide survey. Eur J Neurol 21:1055\u20131059. https:\/\/doi.org\/10.1111\/ene.12442","journal-title":"Eur J Neurol"},{"key":"6389_CR9","first-page":"55","volume":"5","author":"JL Smith","year":"1985","unstructured":"Smith JL (1985) Whence pseudotumor cerebri? J Clin Neuroophthalmol 5:55\u201356","journal-title":"J Clin Neuroophthalmol"},{"key":"6389_CR10","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.jcjo.2013.09.015","volume":"49","author":"LL Bursztyn","year":"2014","unstructured":"Bursztyn LL, Sharan S, Walsh L, LaRoche GR, Robitaille J, De Becker I (2014) Has rising pediatric obesity increased the incidence of idiopathic intracranial hypertension in children? Can J Ophthalmol 49:87\u201391. https:\/\/doi.org\/10.1016\/j.jcjo.2013.09.015","journal-title":"Can J Ophthalmol"},{"key":"6389_CR11","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1016\/j.braindev.2013.09.007","volume":"36","author":"A De\u011ferliyurt","year":"2014","unstructured":"De\u011ferliyurt A, Teber S, Karakaya G, G\u00fcven A, \u015eeker ED, Arhan EP et al (2014) Pseudotumor cerebri\/idiopathic intracranial hypertension in children: an experience of a tertiary care hospital. Brain Dev 36:690\u2013699. https:\/\/doi.org\/10.1016\/j.braindev.2013.09.007","journal-title":"Brain Dev"},{"key":"6389_CR12","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.ajo.2014.11.003","volume":"159","author":"GL Paley","year":"2015","unstructured":"Paley GL, Sheldon CA, Burrows EK, Chilutti MR, Liu GT, McCormack SE (2015) Overweight and obesity in pediatric secondary pseudotumor cerebri syndrome. Am J Ophthalmol 159:344\u201352.e1. https:\/\/doi.org\/10.1016\/j.ajo.2014.11.003","journal-title":"Am J Ophthalmol"},{"key":"6389_CR13","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1177\/0883073820972231","volume":"36","author":"E Yamamoto","year":"2021","unstructured":"Yamamoto E, Farber D, Rothner D, Moodley M (2021) Assessment of Pediatric Pseudotumor Cerebri Clinical Characteristics and Outcomes. J Child Neurol 36:341\u2013349. https:\/\/doi.org\/10.1177\/0883073820972231","journal-title":"J Child Neurol"},{"key":"6389_CR14","unstructured":"Parker APJ. Idiopathic Intracranial Hypertension (Pseuotumor Cerebri). In: Kliegman RM, Geme ST, Blum NJ, Shah SS, Tasker RC and Wilson KM. Nelson Textbook of Pediatrics, International Edition, vol. 1, 2019. p. 623"},{"key":"6389_CR15","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1136\/jnnp-2017-317440","volume":"89","author":"SP Mollan","year":"2018","unstructured":"Mollan SP, Davies B, Silver NC, Shaw S, Mallucci CL, Wakerley BR et al (2018) Idiopathic intracranial hypertension: consensus guidelines on management. J Neurol Neurosurg Psychiatry 89:1088\u20131100. https:\/\/doi.org\/10.1136\/jnnp-2017-317440","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"6389_CR16","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.jsbmb.2016.12.002","volume":"173","author":"N Binkley","year":"2017","unstructured":"Binkley N, Dawson-Hughes B, Durazo-Arvizu R, Thamm M, Tian L, Merkel JM et al (2017) Vitamin D measurement standardization: The way out of the chaos. J Steroid Biochem Mol Biol 173:117\u2013121. https:\/\/doi.org\/10.1016\/j.jsbmb.2016.12.002","journal-title":"J Steroid Biochem Mol Biol"},{"key":"6389_CR17","doi-asserted-by":"publisher","first-page":"4928","DOI":"10.3390\/nu14224928","volume":"14","author":"Y Hu","year":"2022","unstructured":"Hu Y, Jiang S, Lu J, Yang Z, Yang X, Yang L (2022) Vitamin D Status for Chinese Children and Adolescents in CNNHS 2016\u20132017. Nutrients 14:4928. https:\/\/doi.org\/10.3390\/nu14224928","journal-title":"Nutrients"},{"key":"6389_CR18","doi-asserted-by":"publisher","unstructured":"Braegger C, Campoy C, Colomb V, Decsi T, Domellof M, Fewtrell M, et al.; ESPGHAN Committee on Nutrition. Vitamin D in the healthy European paediatric population. J Pediatr Gastroenterol Nutr 2013;56:692\u2013701. https:\/\/doi.org\/10.1097\/MPG.0b013e31828f3c05.","DOI":"10.1097\/MPG.0b013e31828f3c05"},{"key":"6389_CR19","unstructured":"Ross AC, Taylor CL, Yaktine AL, Del Valle HB, IOM (Institute of Medicine). 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press."},{"key":"6389_CR20","doi-asserted-by":"publisher","unstructured":"Hicks CL, Von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale \u2013 Revised: toward a common metric in pediatric pain measurement. Pain 93(2):p 173\u2013183, August 2001. | https:\/\/doi.org\/10.1016\/S0304-3959(01)00314-1","DOI":"10.1016\/S0304-3959(01)00314-1"},{"key":"6389_CR21","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.jped.2020.08.006","volume":"97","author":"VI Fiamenghi","year":"2021","unstructured":"Fiamenghi VI, Mello ED (2021) Vitamin D deficiency in children and adolescents with obesity: a meta-analysis. J Pediatr (Rio J) 97:273\u2013279. https:\/\/doi.org\/10.1016\/j.jped.2020.08.006","journal-title":"J Pediatr (Rio J)"},{"key":"6389_CR22","doi-asserted-by":"publisher","first-page":"e152","DOI":"10.1542\/peds.2012-1711","volume":"131","author":"CB Turer","year":"2013","unstructured":"Turer CB, Lin H, Flores G (2013) Prevalence of vitamin D deficiency among overweight and obese US children. Pediatrics 131:e152\u2013e161. https:\/\/doi.org\/10.1542\/peds.2012-1711","journal-title":"Pediatrics"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-025-06389-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-025-06389-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-025-06389-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T15:04:57Z","timestamp":1760367897000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-025-06389-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":22,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["6389"],"URL":"https:\/\/doi.org\/10.1007\/s00431-025-06389-x","relation":{},"ISSN":["1432-1076"],"issn-type":[{"type":"electronic","value":"1432-1076"}],"subject":[],"published":{"date-parts":[[2025,9,15]]},"assertion":[{"value":"4 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 July 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 September 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Research Ethics Board of Rabin Medical Center, which waived the requirement for informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}],"article-number":"618"}}