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Pseudotumor Cerebri Information

  • Idiopathic intracranial hypertension (IIH), sometimes called benign intracranial hypertension (BIH) or pseudotumor cerebri (PTC) is a neurological disorder that is characterized by increased intracranial pressure (ICP), in the absence of a tumor or other diseases affecting the brain or its lining. Diagnosis requires brain scans and lumbar puncture...
  • Symptoms of Pseudotumor Cerebri

    Characteristic symptoms of IIH are headache in 94%, transient visual obscurations or transient visual loss in one or both eyes usually lasting seconds (68%), pulse synchronous tinnitus (a "wooshing noise" in the ear) (58%) double vision (38%), and visual loss (30%).

    If untreated, complete loss of vision is possible. While IIH may develop in any age group and in both males and females, it is more likely in females of fertile age (15-45) who are overweight or obese. Certain medications (hormonal contraception, vitamin A, tetracycline antibiotics) may increase risk of IIH.

    Physical findings in IIH are characterized by papilledema, loss of visual acuity and visual fields, and absence of focal neurological findings (e.g. face, arm or leg weakness, sensory disturbance or coordination loss). Diplopia (double vision), if present, may be due to abducens nerve palsy (the sixth cranial nerve). Absence of papilledema, while making IIH less likely, is possible.

    Treatment of Pseudotumor Cerebri

    The primary goal in treatment of IIH is the prevention of visual loss and blindness. IIH is treated mainly through the attempted reduction of CSF pressure and, where applicable, weight loss. IIH may resolve after initial treatment, may go into remission and relapse at a later stage, or may continue chronically. If the intracranial hypertension is secondary to medication, these need to be discontinued.

    CSF pressure may be temporarily decreased by repeated "therapeutic" (as opposed to diagnostic) lumbar punctures (to remove excessive cerebrospinal fluid). However, this is generally regarded as a "holding measure" until medical or surgical treatment has been instituted.

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