Pseudotumor cerebri is a condition in which patients have elevated intracranial pressure without the presence of hydrocephalus, a tumor or other mass lesion in the brain. In some patients, the condition can be associated with anomalies of the veins of the brain that lead to increased pressure.
Although pseudotumor cerebri can occur in persons of normal weight, it is more commonly found in obese patients. It is more common in females than males.
The most common symptom is headache, which may be severe and difficult to treat. Patients may also experience visual loss, which can progress to blindness in severe cases.
An MRI of the brain can confirm the absence of a mass lesion, hydrocephalus or other cause of a patient’s symptoms. A magnetic resonance venogram (MRV) may be used to screen for anomalies of the large veins of the brain (called venous sinuses). Ophthalmology evaluation, along with formal visual-field testing, is important to assess for visual loss. The diagnosis of pseudotumor cerebri is often confirmed by elevated opening pressures on lumbar puncture (spinal tap).
In patients who are overweight, the best treatment is an aggressive weight loss program. This should be coordinated by the patient’s pediatrician and/or a nutritionist.
Additional medical treatment options include:
If medical management is not effective, a patient may require surgical treatments, which can include:
Patients with anomalies of the veins of the brain may be treated with endovascular procedures in which the venous drainage of the brain is improved by using a catheter threaded from an artery in the leg into the sinuses.
Because of the possibility of permanent visual loss, patients should be followed closely by a pediatric ophthalmologist and a pediatric neurosurgeon. Care of patients with pseudotumor cerebri may also be managed by pediatric neurologists.
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Pediatric Neurosurgery Clinic
UT Professional Building
6410 Fannin, Suite 950
Houston, TX 77030
P: (832) 325-7242
F: (713) 512-2221
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