Pseudotumor cerebri occurs when the pressure within the skull, or intracranial pressure, increases for no apparent reason. This increased pressure causes symptoms of a tumor in the brain. Because there is actually no tumor present, the condition is referred to as pseudotumor or false tumor. Pseudotumor cerebri is a serious condition that may cause loss of vision. Doctors may also use the term benign intracranial hypertension. However, the medical profession is trying to get away from using both of the terms benign intracranial hypertension and pseudotumor cerebri because it decreases the actual seriousness of the condition. The correct term is idiopathic intracranial hypertension or IIH.
The main symptom of IIH is increased pressure inside your skull. Increased intracranial pressure causes papilledema, or elevated, swollen optic nerves. The optic nerve is the nerve cable that connects your eye to your brain. Because of this swelling, vision can be severely affected and blindness may even occur. Common symptoms of IIH include:
- Headache which may worsen with position change
- Pain caused by eye movement
- Blurred or dimmed vision
- Double vision
- Tinnitus, or ringing in the ears
In most cases of IIH, the exact cause is not known. The condition may be caused by excess levels of cerebrospinal fluid within your skull. Pseudotumor seems to be most common in obese females of childbearing age. Certain medications may increase your risk for developing IIH, including excessive dosages of vitamin A, tetracycline, minocycline, nalidixic acid, corticosteroids, and corticosteroid withdrawal. Some heath conditions that may also increase your risk include endocrinologic abnormalities, anemias, blood dyscrasias, and chronic respiratory insufficiency. However, the majority of cases remain unknown.
Eye doctors are often first to suspect IIH because of changes in your vision and the appearance of the optic nerve. The following tests may be used if pseudotumor cerebri is suspected:
- Visual acuity
- Visual field testing
- Dilated internal eye exam
- Eye muscle testing
- Color vision
Additional testing, such as blood tests, MRI, CT scan, and spinal tap may be needed to confirm the diagnosis and to rule out other conditions that are causing increased intracranial pressure.
Treatment of pseudotumor cerebri focuses on lowering your intracranial pressure. This may be achieved by altering your diet by reducing fluid and salt intake. Certain medications may also be given, such as corticosteroids, acetazolamide or furosemide. Surgery may also be required in more severe cases, focusing on creating windows or shunts to reduce fluid buildup around the optic nerve, brain, and spinal cord.
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IIH usually improves with treatment. However, it sometimes worsens with time, or it can resolve and then recur. round 5-10 percent of women with IIH experience disabling vision loss. Most people with the condition do not require surgical treatment.