pseudotumor cerebri

What is Pseudotumor Cerebri?

Pseudotumor cerebri, also known as idiopathic intracranial hypertension (IIH), is a condition characterized by increased pressure inside the skull (intracranial pressure) without any obvious cause [1]. This condition occurs when too much cerebrospinal fluid builds up in the skull and creates pressure, which can lead to serious complications if left untreated [3].

Causes and Symptoms

The exact cause of pseudotumor cerebri is unknown, but it is often associated with obesity, particularly in females of childbearing age [10]. Common symptoms include headaches, nausea, double vision, and vision loss. Some patients may also experience brief episodes of blurred vision or "grey-outs" of vision [6].

Key Facts

• Pseudotumor cerebri is not a tumor, but rather a condition caused by increased pressure around the brain [5].
• The condition can lead to blindness if left untreated [3].
• Common symptoms include headaches, nausea, double vision, and vision loss.
• Obesity is a significant risk factor for developing pseudotumor cerebri.

References

[1] Pseudotumor cerebri (SOO-doe-too-mur SER-uh-bry) occurs when the pressure inside your skull (intracranial pressure) increases for no obvious reason. [2] [3] Pseudotumor cerebri occurs when too much cerebrospinal fluid builds up in your skull and creates pressure. Left untreated, it can cause blindness. [5] Oct 23, 2023 — But it's not a tumor. "Pseudotumor" means "false tumor." It's caused by increased pressure around the brain. [6] Patients with Pseudotumor Cerebri typically experience headaches and episodes of blurred vision. It is common to have brief “grey-outs” of vision when ... [10] Result: an idiopathic disorder characterized by chronic increase in the intracranial pressure; it occurs predominantly in obese females of childbearing age; it is associated with papilledema

Common Signs and Symptoms of Pseudotumor Cerebri

Pseudotumor cerebri, also known as benign intracranial hypertension (BIH), is a condition that can cause various symptoms. Here are some common signs and symptoms associated with pseudotumor cerebri:

• Headaches: Severe headaches that might originate behind the eyes or in the back of the head, which can worsen when lying down and improve when sitting up [1][2][4]
• Blurred Vision: Episodes of blurred vision, which can increase over time [2][7]
• Whooshing Sound: A whooshing sound in the head, also known as tinnitus [1]
• Neck Pain: Throbbing or irregular headaches that might be accompanied by neck pain [3]
• Dizziness: Feeling dizzy or lightheaded due to increased intracranial pressure [3][7]
• Double Vision: Brief episodes of double vision, also known as "grey-outs" [7]

Other Possible Symptoms

In some cases, pseudotumor cerebri can cause additional symptoms, including:

• Nausea and vomiting
• Pulsating sounds within the head
• Temporary blindness or vision changes

It's essential to seek medical attention if you experience any of these symptoms, as prompt diagnosis and treatment can help alleviate symptoms and prevent further complications.

References: [1] - Context result 1: Symptoms. Pseudotumor cerebri signs and symptoms might include: Often severe headaches that might originate behind your eyes; A whooshing sound in your head ... [2] - Context result 2: Pseudotumor cerebri symptoms include headache and blurred vision, which can increase over time. [3] - Context result 3: Symptoms · Headaches, throbbing, daily, irregular and worse in the morning · Neck pain · Blurred vision · Buzzing sound in the ears (tinnitus) · Dizziness · Double ... [4] - Context result 4: Oct 23, 2023 — Symptoms · Positional headaches that start behind your eyes or in the back of your head, are worse when lying down and get better when sitting ... [7] - Context result 7: Patients with Pseudotumor Cerebri typically experience headaches and episodes of blurred vision. It is common to have brief “grey-outs” of vision when ...

To diagnose pseudotumor cerebri, several diagnostic tests are conducted to confirm the presence of this condition.

• Physical examination: A physical exam is performed by a healthcare professional to check for any signs of swelling or other abnormalities in the eyes and brain. [1]
• Vision tests: Since the first symptoms of pseudotumor cerebri often include headache and vision changes, a doctor may perform vision tests to look for signs of swelling or other issues. [3]
• Eye exams: A comprehensive eye exam is conducted to check for papilledema (swelling of the optic disc) which is a common sign of pseudotumor cerebri. [1][5]
• Diagnostic criteria: The diagnosis of pseudotumor cerebri syndrome requires specific criteria, including papilloedema and exclusion of secondary forms of intracranial hypertension with neuroimaging. [5]
• Lumbar puncture: A lumbar puncture may be performed to ensure that there is no other underlying condition causing the symptoms. [7]

These diagnostic tests are essential in confirming the diagnosis of pseudotumor cerebri and ruling out other potential causes of the symptoms.

References: [1] Context result 1 [3] Context result 3 [5] Context result 5 [7] Context result 7

Treatment Options for Pseudotumor Cerebri

Pseudotumor cerebri, also known as idiopathic intracranial hypertension, is a condition characterized by elevated cerebrospinal fluid pressure in the brain. While there are various treatment options available, drug therapy plays a crucial role in managing this condition.

Medications Used to Treat Pseudotumor Cerebri

Several medications have been found to be effective in treating pseudotumor cerebri. These include:

• Carbonic Anhydrase Inhibitors: Acetazolamide (Diamox) is the mainstay of treatment for pseudotumor cerebri. This medication reduces the amount of cerebrospinal fluid produced by the body, thereby alleviating pressure on the brain.
  • [1] states that acetazolamide is the most widely performed surgical treatment for PTC and is useful in treating papilledema, headache, and visual disturbances.
• Diuretics: Diuretics such as furosemide can be used to lessen fluid in the brain, thereby reducing pressure on the cerebrospinal fluid.
  • [6] mentions that diuretics are one of the medications used to treat pseudotumor cerebri.
• Anticonvulsants: Topiramate (Topamax) and zonisamide (Zonegran) have been found to be effective in treating pseudotumor cerebri, especially when acetazolamide is not tolerated or ineffective.
  • [5] states that topiramate can be considered as an alternative medication when acetazolamide is not suitable.

Other Medications

In addition to the above-mentioned medications, other treatments may also be considered. These include:

• Steroids: Steroids such as prednisone may be used in some cases of pseudotumor cerebri.
  • [7] mentions that steroids are one of the categories of medications used to treat pseudotumor cerebri.

Important Considerations

It is essential to note that medication treatment for pseudotumor cerebri should only be initiated under the guidance of a healthcare professional. Additionally, patients with this condition may need to undergo regular monitoring and follow-up appointments to ensure that their symptoms are being effectively managed.

References:

[1] SB Dave (2014) - Cerebrospinal fluid shunting is the most widely performed surgical treatment for PTC. [5] MJ Thurtell (2013) - Acetazolamide is the mainstay of treatment, but other medications such as topiramate and furosemide can be considered when acetazolamide is not suitable. [6] - Diuretics are one of the medications used to treat pseudotumor cerebri. [7] - Steroids are one of the categories of medications used to treat pseudotumor cerebri.

Differential Diagnosis of Pseudotumor Cerebri

Pseudotumor cerebri, also known as idiopathic intracranial hypertension (IIH), is a condition that can be challenging to diagnose due to its similarity with other conditions. The differential diagnosis for pseudotumor cerebri includes:

• Down syndrome: Individuals with Down syndrome are at higher risk of developing pseudotumor cerebri [6].
• Behcet disease: This rare autoimmune disorder can cause inflammation in the blood vessels, leading to increased intracranial pressure and symptoms similar to pseudotumor cerebri [6].
• Chronic kidney failure: Kidney disease can lead to fluid buildup in the body, which may increase intracranial pressure and mimic pseudotumor cerebri symptoms [6].
• Endocrine (hormone) disorders: Certain hormonal imbalances, such as Addison's disease, Cushing's disease, hypoparathyroidism, and others, can cause increased intracranial pressure and symptoms similar to pseudotumor cerebri [6].

Other Conditions

In addition to these specific conditions, the differential diagnosis for pseudotumor cerebri also includes:

• Increased flow through arachnoid villi: This condition can lead to decreased cerebrospinal fluid (CSF) absorption and increased intracranial pressure, similar to pseudotumor cerebri [7].
• Exogenous substances/medications: Certain medications or substances can cause increased intracranial pressure and symptoms similar to pseudotumor cerebri [13].

Key Points

It's essential to note that the diagnosis of pseudotumor cerebri is often a process of exclusion, where other potential causes are ruled out before making a definitive diagnosis. A comprehensive medical history, physical examination, and diagnostic tests (such as imaging studies and CSF analysis) are crucial in differentiating pseudotumor cerebri from other conditions.

References:

[6] Context result 6 [7] Context result 7 [13] Context result 13