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Pseudotumor Cerebri

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

Symptoms

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

  • Vomiting

  • Neck stiffness

  • Difficulty walking

  • Frequent headaches, often along with nausea or vomiting

  • Persistent ringing in the ears (tinnitus)

  • Forgetfulness

  • Depression

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.

Diagnosis

A physical examination and a few diagnostic tests can help to identify pseudotumor cerebri and rule out a real tumor.

A doctor may perform the following tests:

  • MRI or CT scans of the brain

  • Spinal tap (also called a lumbar puncture) to withdraw a sample of fluid from around the spine

  • Exam to test eye function

In order to properly diagnose pseudotumor cerebri, a doctor will generally need to rule out another health problem as the cause of the symptoms. A doctor will also likely perform tests to make sure that there isn’t an actual brain tumor.

Treatment

Treatment can vary based on what's causing the fluid to build up inside the skull. Treatment options include:

  • Starting a weight loss plan

  • Limiting fluids or salt in the diet

  • Surgical placement of shunt, or special tube, to redirect fluid from the brain and ease pressure buildup

  • Undergoing a spinal tap to remove fluid and alleviate pressure

  • Treatment with medications, such as diuretics, which help the body to get rid of extra fluid

Calling the doctor

Any changes in vision should be checked out by a doctor immediately. An accurate diagnosis and appropriate treatment can help to prevent long-term complications from pseudotumor cerebri, such as partial vision loss and blindness.

Prevention

Since obesity has been linked to pseudotumor cerebri, following a healthy, low-fat diet and getting plenty of exercise may help reduce your risk for the condition.

Complications

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.

It's also possible for pseudotumor cerebri symptoms to occur again even after the condition has already been treated. Regular checkups with your doctor to help monitor symptoms and screen for an underlying problem are important.

Key points to remember

Just because pseudotumor cerebri isn't an actual brain tumor doesn't mean that it isn't a potentially serious health condition. Seeing a doctor to promptly diagnose symptoms and begin treatment can help to prevent complications.

Online Medical Reviewer: Foster, Sara M., RN, MPH
Online Medical Reviewer: Sohrabi, Farrokh, MD
Date Last Reviewed: 5/8/2012
© 2000-2014 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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