Pseudotumor Cerebri

By Dr. Ben Lynch
Updated 2024-03-09 05:28:53 | Published 2022-09-08 16:40:07
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An abstract illustration of Pseudotumor Cerebri

Pseudotumor cerebri, also known as idiopathic intracranial hypertension (IIH), is a condition characterized by increased pressure within the skull, resembling the symptoms of a brain tumor without an actual tumor being present. It primarily affects women of reproductive age, but can also occur in men and children. The exact cause of pseudotumor cerebri is still unknown, although it is believed to be related to the abnormal production or absorption of cerebrospinal fluid.

Pseudotumor Cerebri

What is Pseudotumor Cerebri?

Pseudotumor cerebri, also known as idiopathic intracranial hypertension, is a condition where the pressure inside the skull increases for no obvious reason. It mimics symptoms of a brain tumor, although there's no actual tumor present.

What Causes Pseudotumor Cerebri?

The exact cause of pseudotumor cerebri is unknown. It may be associated with excess cerebrospinal fluid production or poor absorption, obesity, certain medications, and hormonal changes.

What are the Symptoms of Pseudotumor Cerebri?

Symptoms include headaches, vision problems, ringing in the ears, neck, shoulder or back pain, nausea, and vomiting. The headaches may worsen with eye movement.

How is Pseudotumor Cerebri Diagnosed?

Diagnosis involves a neurological examination, eye exam, imaging tests like MRI or CT scans, and possibly a lumbar puncture to measure cerebrospinal fluid pressure.

What Treatment Options are Available for Pseudotumor Cerebri?

Treatment may include weight loss, medications to reduce fluid production or to relieve symptoms, and, in severe cases, surgical options like optic nerve sheath fenestration or shunting procedures.

Can Pseudotumor Cerebri Lead to Vision Loss?

Yes, if left untreated, pseudotumor cerebri can lead to swelling of the optic disc (papilledema), which can ultimately result in vision loss.

Is Pseudotumor Cerebri a Chronic Condition?

It can be chronic for some individuals, requiring long-term management. However, for others, it may resolve with treatment. Regular monitoring and follow-up care are essential.

Symptoms of pseudotumor cerebri may include severe headaches, visual disturbances, such as blurry vision or double vision, pulsatile tinnitus (ringing in the ears), nausea, and vomiting. These symptoms are often aggravated by activities that increase intracranial pressure, such as bending over or coughing.

Diagnosis of pseudotumor cerebri involves a thorough medical history, eye examination, imaging tests (such as MRI or CT scan), and a lumbar puncture to measure cerebrospinal fluid pressure. Treatment usually aims to relieve symptoms and reduce intracranial pressure. This may involve medications, such as diuretics or pain relievers, weight loss interventions, or in severe cases, surgical intervention to divert cerebrospinal fluid flow.

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Long-term management of pseudotumor cerebri may involve regular monitoring of symptoms and intracranial pressure, as well as ongoing treatment to control symptoms and prevent vision loss. With appropriate diagnosis and treatment, individuals with pseudotumor cerebri can experience significant improvement in their symptoms and quality of life.

  1. Headaches: Persistent headaches are a common symptom of Pseudotumor Cerebri. They can range from mild to severe and may worsen with activity or changes in position.
  2. Blurred Vision: Individuals with Pseudotumor Cerebri may experience blurry or double vision. This symptom can affect one or both eyes.
  3. Pulsatile Tinnitus: Pulsating or whooshing sounds in the ears (tinnitus) may be present. The sounds may coincide with the individual's heartbeat.
  4. Neck and Shoulder Pain: Some people with Pseudotumor Cerebri may experience neck and shoulder pain, which can be constant or intermittent.
  5. Nausea and Vomiting: Persistent nausea and occasional vomiting are possible symptoms of this condition.
  6. Dizziness: Feeling lightheaded or dizzy could be a symptom of Pseudotumor Cerebri.
  7. Papilledema: Swelling of the optic disc (papilledema) can occur due to increased intracranial pressure. This can lead to optic nerve damage if left untreated.
  8. Visual Field Defects: Some individuals may experience visual field defects, such as blind spots or loss of peripheral vision.
  9. Difficulty Sleeping: Insomnia or difficulty falling asleep and staying asleep might be experienced by some individuals.
Disease Causes
Pseudotumor Cerebri
  • Idiopathic (unknown cause)
  • Obesity
  • Medications such as corticosteroids, tetracycline, and growth hormones
  • Vitamin A excess
  • Anemia
  • Hypervitaminosis D
  • Endocrine disorders
  • Obstructive sleep apnea
  • Lupus
  • Polycystic ovary syndrome
  • Addison's disease
  • Chronic kidney disease
  • Certain antibiotics
  • Pregnancy

Diagnostic Methods

1. Physical Examination

A doctor may perform a physical examination to check for symptoms and signs of increased intracranial pressure, such as swollen optic nerves.

2. Neurological Examination

A neurological examination may be conducted to assess reflexes, muscle strength, coordination, and sensation. This can help identify any neurological abnormalities associated with pseudotumor cerebri.

3. Eye Examination

An eye examination, including visual acuity tests and a dilated fundus examination, is crucial in diagnosing pseudotumor cerebri. It helps evaluate the optic nerves and detect any abnormalities or swelling.

4. Lumbar Puncture (Spinal Tap)

A lumbar puncture may be performed to measure the pressure of cerebrospinal fluid. Increased pressure in the cerebrospinal fluid can indicate pseudotumor cerebri.

5. Imaging Tests

Various imaging tests may be used to assess the brain, including:

  • Magnetic Resonance Imaging (MRI): Helps identify any structural abnormalities or underlying causes of pseudotumor cerebri.
  • Computed Tomography (CT) Scan: Provides detailed images of the brain to rule out other possible causes of increased intracranial pressure.
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