Pseudotumor Cerebri Syndrome
Treating Idiopathic Intracranial Hypertension to Prevent Vision Loss
Jun 4, 2009
Pseudotumor cerebri syndrome, also called idiopathic intracranial hypertension, is a condition in which there is increased pressure in the skull caused by a buildup of cerebrospinal fluid around the brain.
Pseudotumor cerebri, which literally means “a false tumor of the brain”, mimics some of the signs and symptoms of a brain tumor although there is no presence of one. This disorder occurs more often in women than men; especially overweight women aged 20 to 50.
One possible symptom of idiopathic intracranial hypertension is vision loss in one or both eyes. This may be caused by an increase in intracranial pressure. Fortunately, several procedures can relieve intracranial pressure when a person’s vision is threatened. In some cases, vision loss is reversible.
Causes and Risk Factors of Idiopathic Intracranial Hypertension
The exact cause of this disorder is unknown; however, it may be linked to the increased amount of cerebrospinal fluid in the skull or a problem in the re-absorption process of this fluid.
As mentioned earlier women are most affect by this disorder. However, in the October 15, 2008 issue of Neurology, a study conducted by Dr. B.B.Bruce and colleagues concluded that “men with idiopathic intracranial hypertension(IIH) are twice as likely as women to develop severe visual loss.”
There are medications and health problems that may increase a person’s risk factor for this disorder. Some of these medications are sulfa drugs, tetracycline, lithium, minocycline, birth control pills, and steroids. Idiopathic intracranial hypertension is also observed in some people with certain health conditions such as lupus, hypoparathyroidism, obesity, pregnancy, and kidney disease.
Symptoms of Pseudotumor Cerebri
In addition to increased intracranial pressure, other common symptoms of pseudotumor cerebri include:
- Headaches
- Nausea and vomiting
- Tinnitus
- Blurred vision
- Double vision
- Partial or permanent blindness
Treating Pseudotumor Cerebri
Before treatment, a patient who exhibits these symptoms undergoes a series of exams and tests. Doctors will check for swelling of the optic nerve and perform tests like CT scans, MRIs, spinal taps, and complete vision exams. Once this condition is diagnosed, treatment is dependent on the underlying factors and symptoms.
Obese people will need to make lifestyle changes. Doctors can also prescribe, acetazolamide, a drug that minimizes the production of the cerebrospinal fluid. When medications such as steroids are responsible for pseudotumor cerebri, cessation of these medications may resolve the problem. To treat severe headaches, migraine medication is one possibility. Lumbar punctures or spinal taps can also be performed to reduce cerebrospinal fluid buildup in the brain.
Nevertheless, when the condition affects vision, other procedures may be necessary to prevent permanent vision loss.
Idiopathic Intracranial Hypertension and Vision Loss
An increase in intracranial pressure can affect the optic nerve fibers. When these are under pressure, there can be a decrease in blood flow to the optic nerve. This can result in papilledema, which is a swelling of the optic nerve head. If idiopathic intracranial hypertension is left untreated, papilledema can damage the optic nerve and lead to partial or permanent vision loss. People with recurring or chronic idiopathic intracranial hypertension are particularly at risk for vision loss.
According to the National Library of Medicine and the National Institute of Health, this condition may disappear on its own within six months but there may also be a recurrence of the symptoms in approximately 10 to 20 percent of people with pseudotumor cerebri
Preventing Vision Loss
Thankfully, vision loss is reversible in most patients. It generally depends on the length of time the vision loss has been present. In most patients, there can be full or partial recovery with certain treatments.
In patients with chronic or persistent idiopathic intracranial hypertension, a treatment to relieve the fluid pressure on the optic nerve can be a surgery called optic nerve sheath fenestration. This procedure entails cutting slits or patches in the optic nerve covering. Another surgical procedure performed to remove excess fluid is the placement of a permanent shunt. Vision problems may be significantly improved by these procedures if treatment is started early enough. However, there may be some complications associated with both procedures.
Pseudotumor cerebri can be a life-long disease for people with recurring symptoms such as vision loss. To prevent subsequent vision loss, patient with this disorder should have their vision tested regularly or when they detect any new symptoms.
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