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Year : 2022  |  Volume : 15  |  Issue : 2  |  Page : 222-224

Childhood hypertension, sixth nerve palsy, and renal artery stenosis

1 Department of Ophthalmology, University College of Medical Sciences and Associated GTB Hospital, University of Delhi, New Delhi, India
2 Department of Ophthalmology, Lady Hardinge Medical College and Associated Hospitals, University of Delhi, Dr. RML Hospital and ABVIMS, New Delhi, India

Correspondence Address:
Dr. Zia Chaudhuri
Department of Ophthalmology, Lady Hardinge Medical College and Associated Hospitals, University of Delhi, Dr. RML Hospital and ABVIMS, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ojo.ojo_161_21

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This short report demonstrates an uncommon presentation of intracranial bleeding and sixth nerve palsy in a child with systemic hypertension due to long-standing unilateral renal artery stenosis of unknown etiology that resulted in contracture of the affected kidney and compensatory hypertrophy of the contralateral kidney. Structural renal damage and cardiac ventricular hypertrophy suggested the pathology and ensuing hypertension to be long-standing; however, renal function tests were normal at presentation. The importance of routine outpatient evaluation of systemic blood pressure in children, similar to adults, so as to diagnose and treat secondary hypertension and its causes early, before further systemic and neurological complications set in, is emphasized. The primary neuro-ophthalmological clinical presentation of the child with subsequent confluence of major pediatric domains of medicine, surgery, neurology, cardiology, nephrology, interventional radiology, and ophthalmology toward optimum multidisciplinary etiological and symptomatic management of the condition and its sequelae and subsequent rehabilitation is described.

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