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It most commonly affects women between ages 20 and 50. Symptoms are severe headache, nausea, transient visual obscurations , and vomiting. Additional symptoms vary. The name of the disease comes from the fact that these symptoms are also frequently observed in patients with brain tumor, and the elevated pressure of the CSF on the optic nerves creates papilledema, which also occurs with brain tumors. Risk factors are overweight, use of the oral contraceptive pill and various types of medication (including tetracycline antibiotics and vitamin A).
The diagnosis of BIH is one of exclusion. Due to the possibility of causing a brain herniation if an actual lesion is present, a lumbar puncture (spinal tap) should only be performed after a negative MRI or CT scan. Abnormal high pressure with exclusion of other causation is considered a defintive diagnosis.
The main concern in treatment is preventing visual loss. Elevated CSF levels put pressure on the optic nerves, which causes visual disruptions, and can cause blindness. Prevention of vision loss is a primary concern in treatment.
The treatment of pseudotumor cerebri is primarily symptomatic. Causation is unknown and there is no cure. Psuedotumor cerebri may resolve after initial treatment, may not resolve for years, or may resolve and return chronically.
Pressure may be decreased by repeated spinal taps (to remove excessive cerebrospinal fluidCerebrospinal fluid CSF in short, is the clear fluid that occupies the subarachnoid space (the space between the skull and cortex of the brain). It acts as a "cushion" or buffer for the cortex. Also, CSF occupies the ventricular system of the brain and th), drugs that reduce cerebrospinal fluid production ( acetazolamideAcetazolamide sold under the trade name Diamox is a carbonic anhydrase inhibitor that is used to treat glaucoma, epileptic seizures and altitude sickness. For glaucoma sufferers, the drug decreases fluid formation around the eye resulting in lower interna, Diamox®) or diureticA diuretic is any drug that tends to increase the flow of urine from the body ( diuresis). Some common diuretics are caffeine and alcohol. Medically, diuretics are used to treat heart failure, cirrhosis of the liver, Hypertension and certain kidney diseass. Diamox is the most common CSF inhibitor used in treatment; it can cause drowsiness and hypokalemiaPotassium deficiency is a condition in which the body fails to retain sufficient potassium to maintain health. The condition is also known as hypokalemia . The prefix hypo means low (contrast with hyper meaning high). The middle kal refers to kalium which. Papilledema is a very common sign of BIH. Depending on severity there are other treatment options available, such as optic nerve fenestration, and shunts to remove excess CSF from the brain.
Shunting is a neurosurgicalNeurosurgery is the surgical discipline focused on treating the central and peripheral nervous system. Neurosurgeons undergo a rigorous training program consisting of 6-7 years post-graduate study after medical school. Neurosurgical conditions include pri procedure to facilitate the draining of excess CSF to the normal circulation. There are various types of shunting operations; lumboperitoneal shunts drain from the lumbar spine to the peritoneal cavity, while ventriculoatrial shunts run from the cerebral ventricles to the heart. Although shunts can dysfunction due to occlusion or compression, they are very effective in normalizing CSF pressures.
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