Jonathan Aarons M.D.

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Pseudotumor Cerebri


Pseudotumor Cerebri

Pseudotumor Cerebri is an uncommon and frequently overlooked cause of headaches.  The condition occurs mainly in young females.  It is associated with obesity and birth control pills.  Other predisposing factors include tetracycline, vitamin A, corticosteroids, blood abnormalities, endocrine problems and respiratory disease.  Even though the name “pseudotumor” implies a tumor, that is not the case.  The problem occurs due to an abnormality in the absorption of spinal fluid.  The symptoms include blurred vision, headache, ringing in the ears (tinnitus), nausea and pain in and around the eye.  Diagnosis of pseudotumor cerebri is made by the history of headache, dizziness, and blurred vision along with the finding of increased intracranial pressure.  Often a fundoscopic exam, where the physician will look into the eye with a special instrument, will show increased pressure in the eye.  An MRI or CT scan of the brain is needed to exclude other causes of these symptoms in pseudotumor cerebri.  A lumbar puncture, which is a procedure to check the pressure inside the spinal canal, is necessary to make the complete diagnosis of pseudotumor cerebri.  Treatment of pseudotumor cerebri includes a diuretic, acetazolamide,  and possible a steroid to decrease the pressure inside the brain.  In  cases that are resistant to medications, a cerebrospinal fluid shunt procedure may be necessary.  This procedure allows excess cerebrospinal fluid to drain from the brain and decreases pressure inside the skull.

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