Pseudotumor cerebri, also known as idiopathic intracranial hypertension, is raised pressure around the brain with no mass lesion. It can cause papilloedema and visual loss if untreated.
Symptoms and risk profile
The condition is most common in young overweight women but can affect others.
- Headache, pulsatile tinnitus, and transient visual obscurations
- Blurred vision and enlarged blind spots from swollen optic discs
- Occasional sixth nerve palsy causing double vision
- Normal brain imaging but raised opening pressure on lumbar puncture
Treatment
Management aims to protect vision and reduce pressure.
- Weight loss and acetazolamide as first-line measures
- Regular visual field and optic nerve monitoring
- Optic nerve sheath fenestration or CSF shunting in progressive cases
- Careful review of medications that may contribute, such as tetracyclines or vitamin A derivatives
