Pseudotumor Cerebri



What is pseudotumor cerebri?

Pseudotumor cerebri is a condition in which high cerebrospinal fluid pressure inside your head can cause headaches and problems with your vision. Cerebrospinal fluid is the clear fluid that surrounds the brain and spinal cord. The term “pseudotumor” (which means “false tumor”) comes from the days before brain scans, when doctors who noted swelling of the optic disc (the visible portion of the optic nerve in the back of the eye) considered the possibility of a brain tumor. Patients with optic disc swelling but no evidence of a tumor were said to have a “pseudotumor”.

In Pseudotumor cerebri, the flow of cerebrospinal fluid is blocked from flowing back out of the head as it should, leading to high pressure inside the head. This pressure results in swelling of the optic disc at the back of the eye, which can damage (sometimes permanently) the optic nerve, causing vision loss. High pressure may also cause damage to the nerves that move the eyes, resulting in double vision.


What causes pseudotumor cerebri?

The reason for decreased out flow of cerebrospinal fluid is not clear. Because this condition seems to occur more often in overweight young women, a hormonal influence is suspected. Pseudotumor cerebri may also occur in children, men, and patients who are not overweight. In some cases, antibiotics, steroids or vitamin A may be associated with pseudotumor cerebri.



What are the symptoms of pseudotumor cerebri?

The most common symptoms of pseudotumor cerebri are headaches and visual loss. The headaches may be located anywhere, but are frequently in the back of the neck. This pain may awaken the patient in the middle of the night, and may worsen with bending or stooping.


Symptoms of pseudotumor cerebri include:

· headaches
· pain in the back of the neck
· Dimming, blurring or graying of vision
· Difficulty seeing to the side
· Brief visual disturbances (headaches or neck pain associated with bending and stooping)
· Double vision
· Rushing noises in the ears
· Nausea and vomiting


How is pseudotumor cerebri diagnosed?

Your eye doctor will carefully measure your vision, check the light reaction of your pupils, examine the back of your eye and may evaluate your field of vision. Because other conditions may produce similar symptoms to pseudotumor cerebri, a magnetic resonance imaging (MRI) scan may be necessary for accurate diagnosis.



How is pseudotumor cerebri treated?

If you have no significant headaches or evidence of vision loss (including visual fields), no treatment may be necessary. If you do experience these problems, however, certain medications used in treating glaucoma (such as acetazolamide) can lower the pressure in the head by reducing production of cerebrospinal fluid. Other diuretics (water pills) may also be prescribed. One of the most effective treatments is weight reduction in overweight patients. Surgical Measures may be taken as well in severe and non-responsive cases.

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