Pseudotumor Cerebri

Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)

Pseudotumor cerebri, also known as idiopathic intracranial hypertension (IIH), is a neurological condition in which the pressure around the brain is elevated without the presence of a tumor or other cause on imaging. Although the name means “false brain tumor,” the symptoms can mimic those of a brain tumor and require careful diagnosis and management.

Causes and Risk Factors of Pseudotumor Cerebri

The exact cause of pseudotumor cerebri is unknown, but several factors are associated with increased risk:

• Obesity, especially in women of childbearing age
• Certain medications (such as tetracyclines or excessive vitamin A)
• Hormonal changes
• Blood clotting disorders that affect brain venous drainage

Symptoms

Symptoms can be debilitating and may include:

• Persistent, severe headaches
• Visual disturbances (blurred vision, double vision, or transient vision loss)
• Pulsatile tinnitus (hearing a rhythmic sound in the ears)
• Nausea and vomiting
• Neck or shoulder pain

One of the most concerning complications is vision loss, which can become permanent if not treated.

Diagnosis

Diagnosis of pseudotumor cerebri involves:

• Neurological examination to check for swelling of the optic nerves (papilledema)
• MRI or CT scan to rule out other causes
• Lumbar puncture to measure cerebrospinal fluid (CSF) pressure and confirm elevated intracranial pressure
• Visual field testing to monitor the extent of vision involvement

Treatment Options

The goal of treatment is to reduce intracranial pressure, relieve symptoms, and protect vision.

• Weight loss: Even modest weight reduction can significantly improve symptoms.
• Medications:
  • Acetazolamide (to reduce CSF production)
  • Topiramate (may also aid in weight loss and reduce pressure)
• Therapeutic lumbar punctures: Occasionally used for temporary relief.
• Surgical interventions for more severe or refractory cases:
  • Optic nerve sheath fenestration (to protect vision)
  • Ventriculoperitoneal shunting (to divert CSF and lower pressure)
  • Venous sinus stenting (in selected cases with venous outflow obstruction)

Prognosis of Pseudotumor Cerebri

With early diagnosis and proper treatment, many patients experience significant improvement in symptoms and preservation of vision. Ongoing monitoring is essential to ensure pressure remains controlled and vision is stable.

When to Seek Medical Help

If you experience persistent headaches, vision changes, or pulsatile tinnitus, it’s essential to seek medical evaluation. Prompt diagnosis and management of pseudotumor cerebri can help prevent permanent vision loss.

Contact Us

At Pacific Neuroscience Institute®, our team of experts specializes in diagnosing and treating pseudotumor cerebri with individualized care plans.
Contact us to schedule a consultation.