Pseudotumor Cerebri Information
Pseudotumor Cerebri: Pseudotumor cerebri (SOO-doe-too-mur SER-uh-bry) occurs when the pressure inside your skull (intracranial pressure) increases for no obvious reason. It’s also called idiopathic intracranial hypertension.
Symptoms mimic those of a brain tumor. The increased intracranial pressure can cause swelling of the optic nerve and result in vision loss. Medications often can reduce this pressure and the headache, but in some cases, surgery is necessary. Pseudotumor cerebri can occur in children and adults, but it’s most common in women of childbearing age who are obese.
Pseudotumor Cerebri Wiki
Pseudotumor cerebri is a disorder related to high pressure in the brain that causes signs and symptoms of a brain tumor—hence the term “pseudo” or false tumor. Pseudotumor cerebri is also sometimes known as intracranial hypertension or benign intracranial hypertension.
Pseudotumor cerebri happens when the fluid that surrounds the spinal cord and the brain—called cerebrospinal fluid—accumulates abnormally in the brain. This accumulation of fluid may be because of an increase in fluid production or a decrease in fluid absorption.
Facts about pseudotumor cerebri
Experts don’t know why pseudotumor cerebri happens. Some medications have been linked to an increased risk of developing pseudotumor cerebri, including common medications like oral contraceptives, certain antibiotics, chemotherapy drugs, steroids, and some acne medications.
Anyone can develop pseudotumor cerebri, no matter your age, sex, or body weight. Some people do seem to be at a higher risk for pseudotumor cerebri than others, though. Pseudotumor cerebri occurs more often in women than in men. It’s particularly common in people who are overweight. Pregnant women are at an increased risk of developing pseudotumor cerebri. Having a thyroid condition or chronic kidney failure may also heighten the risk of this disorder.
Pseudotumor cerebri is classified into these categories:
- Acute, which means symptoms happen suddenly, often because of a head injury or stroke
- Chronic, meaning symptoms develop over time and may be caused by an underlying health problem
- Idiopathic, which means that the cause isn’t known
The symptoms of pseudotumor cerebri mimic those of a true brain tumor. The principal sign is unusually high pressure inside the skull, known as intracranial hypertension.
Pseudotumor cerebri can cause:
- Changes in vision (like double vision)
- Vision loss
- Feeling dizzy or nauseated
- Neck stiffness
- Difficulty walking
- Frequent headaches, often along with nausea or vomiting
- Persistent ringing in the ears (tinnitus)
The symptoms of pseudotumor cerebri may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
You may find that certain pseudotumor cerebri symptoms increase when you’re exerting yourself because exercise tends to raise the pressure in the skull higher than when you are at rest.
Pseudotumor Cerebri Symptoms
Pseudotumor cerebri signs and symptoms might include:
- Often severe headaches that might originate behind your eyes
- A whooshing sound in your head that pulses with your heartbeat
- Nausea, vomiting or dizziness
- Vision loss
- Brief episodes of blindness, lasting a few seconds and affecting one or both eyes
- Difficulty seeing to the side
- Double vision
- Seeing light flashes
- Neck, shoulder or back pain
Sometimes, symptoms that have resolved can recur months or years later.
The cause of pseudotumor cerebri is unknown. If a cause is determined, the condition is called secondary intracranial hypertension, rather than idiopathic.
Your brain and spinal cord are surrounded by cerebrospinal fluid, which cushions these vital tissues from injury. This fluid is produced in the brain and eventually is absorbed into the bloodstream at a rate that usually allows the pressure in your brain to remain constant.
The increased intracranial pressure of pseudotumor cerebri might result from a problem in this absorption process.
The following factors have been associated with pseudotumor cerebri:
Obese women of childbearing age are more likely to develop the disorder.
Substances linked to secondary intracranial hypertension include:
- Growth hormone
- Too much vitamin A
Conditions and diseases that have been linked to secondary intracranial hypertension include:
- Addison’s disease
- Blood-clotting disorders
- Kidney disease
- Polycystic ovary syndrome
- Sleep apnea
- Underactive parathyroid glands
Pseudotumor Cerebri Treatment
Pseudotumor cerebri can happen if pressure rises around your brain due to too much cerebrospinal fluid. This fluid surrounds your brain and spinal cord and protects them from injury.
Your body constantly makes cerebrospinal fluid. Then it reabsorbs the fluid through your blood vessels to keep the same amount flowing around your brain and spinal cord.
Sometimes your body makes too much cerebrospinal fluid. Or it doesn’t reabsorb enough fluid. If either of these things happens, the amount of fluid surrounding your brain can rise. This can raise the pressure on your brain and cause swelling of the optic nerve, which sends messages from your eyes to your brain.
Signs you might have this condition include:
- Headaches that start behind your eyes or in the back of your head
- Blurry vision or double vision
- A blackout in your vision that lasts for a few seconds at a time
- Nausea, throwing up
- Ringing in your ears that pulses in time with your heartbeat
- Stiff neck
Your symptoms might get worse when you exercise. This is because activity boosts the pressure in your brain.
Pseudotumor Cerebri Icd 10
The fluid that surrounds the spinal cord and brain is called cerebrospinal fluid or CSF. Cerebrospinal fluid supplies the brain and spinal cord with nutrients and removes impurities while protecting and cushioning these delicate structures.
Normally, after circulating, CSF is reabsorbed into the body through blood vessels. But if too much fluid is produced or not enough is re-absorbed, the CSF can build up and cause pressure within the skull, which is an enclosed space.
This pressure can cause symptoms similar to those of a brain tumor, including worsening headache and vision problems. Untreated pseudotumor cerebri can result in permanent problems such as vision loss.
The most common are headaches and blurred vision. Other symptoms may include:
- Vision changes (like double vision) or vision loss
- Dizziness, nausea and/or vomiting
- Neck stiffness
- Persistent ringing in the ears (tinnitus)
- Forgetfulness and/or depression
Since exertion can increase pressure inside the skull, symptoms can become worse with exercise or physical activity.
Pseudotumor cerebri symptoms may resemble those of many other medical problems. Always consult an experienced specialist for a diagnosis.
Pseudotumor Cerebri Icd10
Idiopathic intracranial hypertension (IIH) is a disorder of unknown etiology that predominantly affects obese women of childbearing age. The primary problem is chronically elevated intracranial pressure (ICP), and the most important neurologic manifestation is papilledema (see the image below), which may lead to secondary progressive optic atrophy, visual loss, and possible blindness. Although IIH, pseudotumor cerebri, and benign intracranial hypertension (BIH) are synonymous terms in the literature, IIH is the preferred term.
Idiopathic intracranial hypertension (IIH, pseudotumor cerebri) is a syndrome of elevated intracranial pressure of unknown cause that occurs predominantly in obese women of childbearing age. It is a diagnosis of exclusion and, therefore, other causes of increased intracranial pressure must be sought with history, imaging, and cerebrospinal fluid examination before the diagnosis can be made.
IIH produces symptoms and signs of increased intracranial pressure, including papilledema. If untreated, papilledema can cause progressive irreversible visual loss and optic atrophy. The treatment approach depends on the severity and time course of symptoms and visual loss, as determined by formal visual field testing. The main goals of treatment are the alleviation of symptoms, including headache, and preservation of vision. All overweight IIH patients should be encouraged to enter a weight-management program with a goal of 5% to 10% weight loss, along with a low-salt diet.
When there is mild visual loss, medical treatment with acetazolamide should be initiated. Other medical treatments can be added or substituted when acetazolamide is insufficient as monotherapy or poorly tolerated. When visual loss is more severe or rapidly progressive, surgical interventions, such as optic nerve sheath fenestration or cerebrospinal fluid shunting, may be required to prevent further irreversible visual loss. The choice of intervention depends on the relative severity of symptoms and visual loss, as well as local expertise. At present, the role of transverse venous sinus stenting remains unclear. Although there are no evidence-based data to guide therapy, there is an ongoing randomized double-blind placebo-controlled treatment trial, investigating diet and acetazolamide therapy for IIH.
Pseudotumor Cerebri Syndrome
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. Symptoms of pseudotumor cerebri, which include headache, nausea, vomiting, and pulsating sounds within the head, closely mimic symptoms of large brain tumors.
Obesity, other treatable diseases, and some medications can cause raised intracranial pressure and symptoms of pseudotumor cerebri. A thorough medical history and physical examination are needed to evaluate these factors. If a diagnosis of pseudotumor cerebri is confirmed, close, repeated ophthalmologic exams are required to monitor any changes in vision. Drugs may be used to reduce fluid buildup and to relieve pressure. Weight loss through dieting or weight loss surgery and cessation of certain drugs (including oral contraceptives, tetracycline, and a variety of steroids) may lead to improvement.
Surgery may be needed to remove pressure on the optic nerve. Therapeutic shunting, which involves surgically inserting a tube to drain CSF from the lower spine into the abdominal cavity, may be needed to remove excess CSF and relieve CSF pressure.
Pseudotumor Cerebri Causes
Idiopathic intracranial hypertension (IIH) is a syndrome of increased intracranial pressure (ICP) of unknown cause that occurs most often in obese women of childbearing age, but can also occur in children, men, and older adults. It is characterized by symptoms and signs of increased ICP; common symptoms include headache, visual loss, diplopia, and pulsatile tinnitus, whereas common signs include papilledema, visual field defects, and sixth nerve palsy.
IIH is a diagnosis of exclusion (see Table 1 for the modified Dandy diagnostic criteria) and, therefore, other causes of increased ICP need to be excluded with imaging (ideally MRI brain and MRV head) and lumbar puncture before the diagnosis can be confirmed. Treatment with certain medications (e.g., vitamin A derivatives, tetracyclines, and lithium) and cerebral venous sinus thrombosis can cause an indistinguishable clinical picture; such conditions must be excluded before IIH can be diagnosed, because they require a different treatment approach (e.g., those with increased ICP due to medications often improve following withdrawal of the offending agent).
Can you die from pseudotumor cerebri?
Pseudotumor cerebri can result in permanent complications if it isn’t treated. Permanent vision loss can occur, so regular eye exams and checkups are usually recommended to treat any eye problems before they progress.
What causes pseudotumor cerebri?
Causes. Pseudotumor cerebri can happen if pressure rises around your brain due to too much cerebrospinal fluid. This fluid surrounds your brain and spinal cord and protects them from injury. Your body constantly makes cerebrospinal fluid.