Idiopathic Intracranial Hypertension (Pseudotumor Cerebri): Symptoms, Causes, Diagnosis, Treatment and Prevention

Idiopathic Intracranial Hypertension (Pseudotumor Cerebri): Symptoms, Causes, Diagnosis, Treatment and Prevention
Idiopathic Intracranial Hypertension (Pseudotumor Cerebri): Symptoms, Causes, Diagnosis, Treatment and Prevention

Pseudotumor cerebri is a condition in which the pressure around your brain increases, causing headaches and vision problems. The name means “false brain tumour,” since its symptoms are similar to those caused by brain tumours. It’s also known as idiopathic intracranial hypertension. It mainly affects women who are between 20 and 50 years old. This condition is treatable, although it can return in some cases.

Signs and symptoms of Pseudotumor Cerebri

Signs and symptoms associated with Pseudotumor cerebri include:

  • Moderate to severe headaches that may start from your eyes and worsen with eye movement
  • Ringing in the ears that pulses in time with your heartbeat
  • Nausea, vomiting or dizziness
  • Blurred or dimmed vision
  • Short episodes of blindness, lasting only a few seconds and affecting one or both eyes
  • Difficulty seeing to the side
  • Double vision
  • Seeing light flashes
  • Neck, shoulder or back pain

The Causes of Pseudotumor Cerebri

The precise cause of this condition is unknown, though it may be associated with having too much cerebrospinal fluid in your skull. This fluid, which protects your brain and spinal cord, is normally absorbed into your bloodstream. Pseudotumor cerebri may occur when this fluid isn’t fully absorbed, which causes it to build up. This leads to increased pressure in your skull.

Diagnosis of Pseudotumor Cerebri

  • Eye Exam: Your eye doctor will check for swelling in the optic nerve at the back of your eye. Your vision will also be tested to see if you have abnormal blind spots.
  • Imaging Tests: Your eye doctor may perform a CT or MRI scan of your brain to look for signs of spinal fluid pressure. These scans can also be used to check for other conditions that could be causing your symptoms, such as tumours or blood clots.
  • Spinal Tap (lumbar puncture): Your eye doctor may also perform a spinal tap, or lumbar puncture, to measure the pressure of your spinal fluid. This involves placing a needle between two bones, or vertebrae, in your back and drawing a fluid sample for testing.

Treatment of Pseudotumor Cerebri

Medications can help control or reduce the symptoms of pseudotumor cerebri. Your doctor might prescribe:

  • Migraine medications to provide headache relief, such as tryptans like sumatriptan and naratriptan
  • Glaucoma drugs, such as acetazolamide, which cause your brain to produce less cerebrospinal fluid. These drugs can cause fatigue, kidney stones, nausea, and a tingling sensation in your mouth, toes, or fingers.
  • Diuretics, such as furosemide, to make you urinate more often. This causes you to retain less fluid in your body, which helps ease the pressure in your skull. These may be used in combination with glaucoma drugs to make them more effective.

Your doctor may recommend surgery if your vision becomes worse or to drain excess cerebrospinal fluid. Surgical procedures include optic nerve sheath fenestration and spinal fluid shunt. Other treatment methods include losing weight and having multiple spinal taps performed to relieve pressure.

Prevention of Pseudotumor Cerebri

Gaining weight puts you at a higher risk of having pseudotumor cerebri. You can help prevent this condition by losing excess body weight and keeping it off. Switching to a healthy diet and getting regular exercise can help you drop the extra weight.

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