About pseudotumor cerebri

What is pseudotumor cerebri?

Pseudotumor cerebri literally means "false brain tumor." It is likely due to high pressure within the skull caused by the buildup or poor absorption of cerebrospinal fluid (CSF). The disorder is most common in women between the ages of 20 and 50.

What are the symptoms for pseudotumor cerebri?

Pseudotumor cerebri signs and symptoms may include:

  • Moderate to severe Headaches that may originate behind your eyes and worsen with eye movement
  • Ringing in the ears that pulses in time with your heartbeat (pulsatile tinnitus)
  • Nausea, Vomiting or dizziness
  • Blurred or dimmed vision
  • Brief episodes of blindness, lasting only a few seconds and affecting one or both eyes (visual obscurations)
  • Difficulty seeing to the side
  • Double vision (diplopia)
  • Seeing light flashes (photopsia)
  • Neck, shoulder or back pain

What are the causes for pseudotumor cerebri?

The exact cause of pseudotumor cerebri in most individuals is unknown, but it may be linked to an excess amount of cerebrospinal fluid within the bony confines of your skull.

Your brain and spinal cord are surrounded by cerebrospinal fluid, which acts like a cushion to protect these vital tissues from injury. This fluid is produced in the brain and eventually is absorbed into the bloodstream. The increased intracranial pressure of pseudotumor cerebri may be a result of a problem in this absorption process.

In general, your intracranial pressure increases when the contents of your skull exceed its capacity. For example, a brain tumor generally increases your intracranial pressure because there's no room for the tumor. The same thing happens if your brain swells or if you have too much cerebrospinal fluid.

Several studies indicate that many people with pseudotumor cerebri have a narrowing (stenosis) in two large sinuses in the brain (transverse sinuses). Studies are determining whether this is an effect or a cause of the condition.

What are the treatments for pseudotumor cerebri?

The goal of pseudotumor cerebri treatment is to improve your symptoms and keep your eyesight from worsening. Depending on your condition, your doctor may prescribe medications or recommend surgery to control your symptoms.

Surgery

    • Optic nerve sheath fenestration. In this procedure, a surgeon cuts a window into the membrane that surrounds the optic nerve. This allows excess cerebrospinal fluid to escape.

      Vision stabilizes or improves in most cases. Most people who have this procedure done on one eye notice a benefit for both eyes. However, this surgery isn't always successful and may even increase vision problems.

    • Spinal fluid shunt. In another type of surgery, your doctor inserts a long, thin tube (shunt) into your brain or lower spine to help drain away excess cerebrospinal fluid.

The tubing is burrowed under your skin to your abdomen, where the shunt discharges the excess fluid. Symptoms may improve for some people who undergo this procedure.

However, shunts can become clogged and often require additional surgeries to keep them working properly. Complications can include low-pressure headaches and infections.

This procedure is generally only a treatment option if other treatments haven't relieved your condition.

If you're obese, your doctor will recommend weight loss. You may work with a dietitian to help with your weight-loss goals. Losing weight may improve your symptoms. Some people who are morbidly obese may benefit from weight-loss programs or gastric surgery to lose weight.

Once you've had pseudotumor cerebri, you should have your vision checked regularly.

What are the risk factors for pseudotumor cerebri?

The following factors have been associated with pseudotumor cerebri:

Obesity

Obesity has been associated with pseudotumor cerebri, which occurs in 1 to 2 people in 100,000. In women who are obese, about 4 to 21 in 100,000 develop the condition. Women under the age of 44 who are obese are more likely to develop the disorder.

Medications

Substances that have been linked to pseudotumor cerebri include:

  • Growth hormone
  • Tetracycline
  • Excess vitamin A

Other medications may be associated with pseudotumor cerebri, but further research is needed.

Health problems

The following conditions and diseases have been linked to pseudotumor cerebri:

  • Addison's disease
  • Anemia
  • Behcet's syndrome
  • Blood-clotting disorders
  • Lupus
  • Kidney disease
  • Polycystic ovary syndrome
  • Sleep apnea
  • Underactive parathyroid glands
  • Uremia

Is there a cure/medications for pseudotumor cerebri?

You’ll need to see your eye doctor regularly to have your vision checked once the pseudotumor cerebri is gone. Your eye doctor will watch you closely to make sure that you don’t continue to have vision changes that could result in permanent vision loss.

You should also let your primary care doctor know if you start having symptoms of this condition again.

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