Pseudotumor Cerebri

Pseudotumor Cerebri

Definition. An idiopathic increase in intracranial pressure also known as benign intracranial hypertension.

Etiology. The disorder is 8 to 10 times more common in women. There is an association with obesity, chronic lung disease, Addison disease, oral contraceptives, tetracycline use, and vitamin A toxicity. Often there is no identified cause and the disorder resolves spontaneously after several months.

Clinical Presentation. Patients present with a headache, visual disturbances such as diplopia, and sixth cranial nerve (abducens) palsy. Clinical findings include diplopia, papilledema, and enlargement of the blind spot on visual field testing. The CT and MRI are normal, and evalu- ation of cerebrospinal fluid is normal beyond an increase in pressure.

Treatment. Treatment consists of weight loss, removing offending agents such as oral con- traceptives, and the use of diuretics such as acetazolamide or furosemide. Steroids such as prednisone may help as well. In urgent cases, repeated lumbar punctures may help. If this is not effective and the disorder does not resolve, definitive treatment can be achieved with the placement of a surgical shunt between the ventricles and the  peritoneum.