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| Pseudotumor Cerebri (PTC) |
Pseudotumor Cerebri (PTC)
Definition:
Pseudotumor cerebri is a condition in which there is:
An increase in the pressure of the fluid surrounding the brain and spinal cord, the cerebrospinal fluid (CSF), leading most commonly
to headache. No detectable problem in the CSF (pressure aside) or in the anatomy of the brain and spinal cord. The cause of the
increased CSF pressure is an unsolved mystery. Pseudotumor cerebri mimics a brain tumor in elevating the CSF pressure. In this
respect, it is like a brain tumor (tumor cerebri, in Latin). Pseudotumor cerebri is also called benign intracranial hypertension
(high pressure within the head).
Causes:
Pseudotumor cerebri in most cases has no known cause.It can occur in association with pregnancy, estrogen treatment, cortisone-related
medications, adrenal or parathyroid gland abnormality, and certain drugs (tetracycline, vitamin A, nalidixic acid).
Symptoms:
Symptoms of pseudotumor cerebri, which include headache, nausea, vomiting, and pulsating intracranial noises, closely mimic symptoms
of brain tumors. Other symptoms include eye pain, vision loss and nerve palsy in the nerve that stimulates the eye muscle that moves
the eye sideways (the 6th cranial nerve). This can lead to double vision.
Treatment:
Some treatable diseases can cause raised intracranial pressure and symptoms of pseudotumor cerebri. A thorough physical examination
is needed to rule out these disorders. If a diagnosis of pseudotumor cerebri is confirmed, hyperosmotic drugs may be used to reduce
fluid buildup. Diuretics are commonly used to relieve pressure. Weight loss and cessation of certain drugs (including oral
contraceptives and a variety of steroids) will lead to improvement. Therapeutic shunting, which involves surgically inserting a
draining tube from the spinal fluid space in the lower spine into the abdominal cavity, may be needed to remove excess fluid and
relieve pressure. Close, repeated ophthalmologic exams are required to monitor any changes in vision. Surgery may be needed to
remove pressure on the optic nerve.
Prognosis:
The disorder may cause progressive, permanent visual loss in some patients. In some cases, pseudotumor cerebri recurs.
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