Tag Archives: pseudotumor

Idiopathic Intracranial Hypertension

(the diagnosis formerly known as pseudotumor cerebri)

  • Presentation = acute, subacute, chronic headache with associated blurry vision or visual loss, papilledema, pulsatile tinnitus (“whooshing sound in ears”), abducens nerve palsy, nausea, vomiting
  • Patients typically young obese women
  • ** Meds to know causing pseudotumor = vitamin A, oral contraceptives, glucocorticoids
  • ** Brain MRI = empty sella, slit like ventricles
  • ** Will have normal brain imaging with elevated CSF pressure
  • Tx = weight reduction, acetazolamide
    • Medical measure fail or visual field defects are progressive –> shunting or optic nerve sheath fenestration
    • Acetazolamide MOA = inhibits choroid plexus carbonic anhydrase –> decrease CSF production and intracranial hypertension

Dandy criteria for dx of IIH:

  1. signs/symptoms of ICP
  2. no other neuro abnormality or impaired consciousness
  3. normal CSF
  4. neuroimaging showing no etiology
  5. no other cause of intracranial hypertension apparent

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