Pseudotumor cerebri

Abstract

Pseudotumor cerebri is an avoidable cause of visual loss, both in adults and children. Few diagnostic measures are usually sufficient to determine the correct diagnosis. Since pseudotumor cerebri is a diagnosis of exclusion, the differential diagnosis work out is of special importance. Modern neuroimaging techniques, especially magnetic resonance imaging and magnetic resonance venography may clarify the role of obstruction to venous outflow in each case. Various therapeutic options are available: medical, surgical, and endovascular procedures may be used to prevent irreversible visual loss. Treatment is usually effective, and most patients will experience complete resolution of symptoms without persistent deficits.

Reevaluation of presentation and course of idiopathic intracranial hypertension - a large cohort comprehensive study

“…Recurrence has been reported in 15–61% of IIH patients according to different studies . We have documented a flare up in 67% of patients during a period of 61.3 ± 62.3 months.…”

Idiopathic Intracranial Hypertension in a pubertal paediatric Indian patient

“…MRI is superior to computed tomography and the findings include tortuosity of the optic nerve, distension of perioptic subarachnoid space, posterior flattening of the globe or empty sella (Shin RK et al, 2001). CSF opening pressure of 25 mm Hg in children of 8 years or older, and opening pressure of 20 mm Hg in those younger than 8 years is diagnostic (Spennato P et al, 2011).…”

“…It may be associated with nausea, vomiting, stiff neck, pulsatile tinnitus, retro-orbital pain, photophobia, dizziness or sensorineural hearing loss (Reitsma S et al, 2015). Neurological examination is normal with the exception of unilateral or bilateral sixth nerve palsies, which occur in 9-48% of children (Wolf A et al, 2008;Rangwala LM et al, 2007 (Spennato P et al, 2011;Standridge SM, 2010) In children suspected of IIH, cranial imaging should be performed prior to LP to exclude a space occupying lesion in the brain. MRI is superior to computed tomography and the findings include tortuosity of the optic nerve, distension of perioptic subarachnoid space, posterior flattening of the globe or empty sella (Shin RK et al, 2001).…”

Volumetric Assessment of Optic Nerve Sheath and Hypophysis in Idiopathic Intracranial Hypertension

“…Initially used terms such as "meningitis serosa" coined by Quincke in 1893 or "pseudotumor cerebri" by Nonne in 1904 are now obsolete and have been replaced in recent classifications by the descriptive denomination "idiopathic intracranial hypertension." 1,2 Because IIH predominantly affects obese women of childbearing age and the incidence of obesity in industrialized countries is growing, IIH has been the focus of recent research. The underlying pathophysiologic mechanism of the disease is not fully understood.…”