Pseudotumor cerebri (aka idiopathic intracranial hypertension) is characterized by an increased intracranial pressure (ICP) in the setting of normal brain imaging and cerebrospinal fluid (CSF) studies.
Etiologies are obesity, OCPs, isotretinoin, tetracyclines, and danazol.
Diagnosis:-
1. Fundoscopic examination shows papilledema.
2. CT scan or MRI of head is normal (rule out secondary cause of raised ICP i.e. mass).
3. Lumbar puncture shows elevated opening pressure of CSF.
Management:-
1. Stop the offending agents (e.g. OCPs, isotretinoin, tetracyclines, danazol).
2. Weight loss, especially in obese individuals.
3. Medical therapy includes acetazolamide (i.e. carbonic anhydrase inhibitor and reduces CSF production).
4. Serial lumbar puncture (LP).
5. Ventriculoperitoneal (VP) shunt.
6. Treatment for severe visual disturbances (e.g. blurred vision and diplopia) is optic nerve fenestration, as it relieves increased intracranial pressure.
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