Malignant pseudotumor cerebri

Abstract

Two young Arab women presented with a very rapid loss of vision, ophthalmoplegia, florid papilledema, areflexia of the lower limbs, and normal mentation. Lumbar puncture pressure was above 60 cm H2O, but no intracranial structural lesion was found in either patient. An exhaustive evaluation as to an etiology was negative in both. Under continuous lumbar cerebrospinal fluid drainage and administration of steroids, furosemide, and acetazolamide, both patients had significantly improved vision and ocular movement. In both, lumboperitoneal shunting was considered but only one eventually underwent this procedure. These two patients with pseudotumor cerebri are unique in their fulminant clinical course and severely increased intracranial pressure. Virtually inevitable blindness was prevented by timely intervention.

Unilateral Transverse Sinus Stenting of Patients with Idiopathic Intracranial Hypertension

“…5,6 Up to 3% of patients develop a fulminant or malignant course with rapidly progressive visual loss. [7][8][9] Treatments focus on normalization of intracranial pressure. Initial therapy usually consists of acetazolamide in conjunction with dietary counseling for weight loss.…”

Fulminant idiopathic intracranial hypertension in a pediatric patient following a minor head trauma

“…Similar reports of fulminant IIH are exceedingly rare in the literature and the pathophysiology remains unknown 9 . Identifiable conditions have been associated with IIH, especially in pediatric patients, the most common of which include drugs (such as tetracyclines, vitamin A, steroids, and chemotherapy agents); infections (acute sinusitis, varicella, measles); and endocrine conditions 1 .…”

Management of pediatric patients with pseudotumor cerebri

“…Decreased visual acuity and visual field occurs in 5-20% of patients at initial presentation, and the course is usually insidious [4,15,18,20]. Acute loss of vision is rare but constitutes a true medical emergency [3,[10][11][12][13]15] ( Table 2). In these isolated cases, the age of patients ranged between 11 and 26 years.…”