Overview
Pseudotumor cerebri is a condition in which the pressure inside the skull increases for no obvious reason. It is also known as idiopathic intracranial hypertension. This increased pressure can cause swelling of the optic nerve and lead to vision loss. The exact cause of pseudotumor cerebri is unknown, but it is more common in obese women of childbearing age. Symptoms may include severe headaches, a whooshing sound in the head, nausea, vomiting, dizziness, neck, shoulder, or back pain, difficulty seeing to the side, double vision, flashes of light, and vision loss. Treatment may involve medications to reduce pressure and headache symptoms, but in some cases, surgery may be necessary.
Understanding the disease
Symptoms
The symptoms of pseudotumor cerebri (idiopathic intracranial hypertension) include severe headaches, a whooshing sound in the head that pulses with the heartbeat, nausea, vomiting, or dizziness, vision loss or difficulty seeing to the side, double vision, seeing light flashes, neck, shoulder, or back pain.
Risk Factors
The risk factors for developing pseudotumor cerebri (idiopathic intracranial hypertension) include obesity, certain medications such as growth hormone, tetracycline, and excessive vitamin A intake. The condition is more common in women of childbearing age who are obese. Other factors associated with increased risk are high blood pressure, high cholesterol, heart problems, osteoarthritis, type 2 diabetes, enlarged thyroid gland (goiter), precancerous colon growths, sleep apnea, carpal tunnel syndrome, increased cancer risk, spinal cord compression or fractures, and vision changes or vision loss.
Development
Pseudotumor cerebri, also known as idiopathic intracranial hypertension, is a condition where the pressure inside the skull increases for no obvious reason. The exact cause of pseudotumor cerebri is unknown, but it is believed to be related to a problem in the absorption process of cerebrospinal fluid. In some cases, pseudotumor cerebri can be linked to certain medications, obesity, or other medical conditions. It is most common in women of childbearing age who are obese. The increased pressure inside the skull can lead to a variety of symptoms, including severe headaches, nausea, vomiting, dizziness, vision loss, and neck, shoulder, or back pain. If you are experiencing any of these symptoms, it is important to consult with your doctor for a proper evaluation and treatment plan.
Assessment and Diagnosis
Triage
You should see a doctor if pseudotumor cerebri is suspected, especially if you experience symptoms such as severe headaches, a whooshing sound in your head, nausea, vomiting, dizziness, vision loss, difficulty seeing to the side, double vision, seeing light flashes, neck, shoulder, or back pain. It is important to seek medical attention immediately if you notice any signs or symptoms of a brain AVM, such as seizures, headaches, or other symptoms, as a bleeding brain AVM can be life-threatening and requires emergency medical attention.
Diagnosis
To diagnose pseudotumor cerebri, your doctor will review your symptoms and medical history, conduct a physical examination, and order tests. These may include eye exams to look for swelling affecting the optic nerve in the back of your eye, a visual field test to check for blind spots in your vision, photos of your eyes, and imaging tests such as MRI or CT scans to rule out other problems like brain tumors. Your doctor may also order a spinal tap (lumbar puncture) to measure the pressure inside your skull and analyze your spinal fluid.
Management and Treatment
Complications
Pseudotumor cerebri (idiopathic intracranial hypertension) can lead to several complications, including:
- Vision loss: The increased intracranial pressure can cause swelling of the optic nerve, resulting in vision loss or other vision-related problems.
- Hydrocephalus: The accumulation of excess cerebrospinal fluid in the brain can lead to hydrocephalus, which may require a shunt to divert and drain the fluid to another area of the body.
- Neurological symptoms: Pressure from the cerebellum on the spinal cord or lower brainstem can cause neurological signs or symptoms, such as neck, shoulder, or back pain.
- Headache persistence: Despite medication, some patients may continue to experience severe headaches.
- Recurrence: In some cases, symptoms that have resolved can recur months or years later.
- Other complications: These may include dehydration, kidney failure, and other conditions associated with a weakened immune system or other comorbidities. It's essential to seek medical attention if you or someone you know experiences symptoms of pseudotumor cerebri. Early diagnosis and treatment can help manage these complications and prevent further progression of the condition.
Treatment
Some treatments for pseudotumor cerebri (idiopathic intracranial hypertension) include:
- Medications: Doctors may prescribe medications to lower the pressure inside the skull, such as diuretics, which help reduce the amount of fluid in the brain. Pain relievers and anti-inflammatory drugs may also be prescribed to alleviate headaches and related symptoms.
- Weight loss: For individuals who are obese, losing weight can help reduce the risk of developing or recurring pseudotumor cerebri.
- Lifestyle modifications: Avoiding certain medications, supplements, or substances that can cause increased intracranial pressure may be recommended.
- Surgical intervention: In some cases, surgery may be necessary to alleviate pressure or to treat underlying conditions such as Chiari malformation or hydrocephalus. It's important to consult with a healthcare professional for a proper diagnosis and to determine the appropriate course of treatment.
Preparing for medical consultation
To prepare for an appointment for pseudotumor cerebri, you should make a list of your symptoms, including any that may seem unrelated to the condition, and when they began. Also, gather information about your personal and family medical history, including major stresses or recent life changes. Bring a list of all medications, vitamins, or supplements you're taking, and don't forget to bring any previous test results or scans. It may be helpful to bring a family member or friend with you to the appointment to provide support and help remember important information. It's also important to ask your doctor any questions you may have about your condition and the recommended course of treatment.