Pseudotumor Cerebri

The exact cause of this condition is unknown, but it may be associated with having too much cerebrospinal fluid in your skull. This fluid, which protects your brain and spinal cord, is normally absorbed into your bloodstream. Pseudotumor cerebri may occur when this fluid isn’t fully absorbed, which causes it to build up. This leads to increased pressure in your skull. This condition can affect children, men, and older adults but occurs most often in women who have obesity and are of childbearing age.

Obesity

Obesity is one of the leading factors that can increase your risk of developing pseudotumor cerebri. According to the Mayo Clinic, the risk is almost 20 times higher in women with obesity who are under 44 years old than in the general population. Children are also at risk. In fact, the U.S. Center for Disease Control reports that 79% of children with secondary pseudotumor cerebri syndrome are overweight or have obesity. Central obesity, or fat around the middle of the abdomen, is associated with a higher risk.

Medications

Certain medications may make you more susceptible to this condition. These include:

• birth control pills
• excessive amounts of vitamin A
• tetracycline, an antibiotic
• steroids (when you stop using them)

Other health conditions

Health conditions associated with pseudotumor cerebri include:

• kidney disease
• sleep apnea, which is abnormal breathing during sleep marked by phases of paused breathing
• Addison’s disease, which is a disorder in which your adrenal glands don’t produce enough hormones
• Lyme disease, which is a chronic flu-like disease caused by a bacterium carried by ticks

A birth defect

Some conditions can lead to narrowing of the blood vessels in your brain. This may make you more likely to develop pseudotumor cerebri. The narrowed veins make it more difficult for fluid to move through your brain.

Headaches

A common symptom of this condition is a dull headache that starts behind your eyes. These headaches can become worse at night, when you move your eyes, or when you first wake up.

Vision problems

You may also have vision problems, such as seeing flashes of light or having brief episodes of blindness or blurred vision. These problems can become worse as the pressure keeps increasing. If left untreated, this can lead to double vision or permanent vision loss.

Other symptoms

Other symptoms include:

• ringing in your ears
• pain in your neck, back, or shoulders
• nausea
• vomiting
• dizziness

Eye exam

Your doctor will check for papilledema, which is swelling of the optic nerve at the back of your eye. The increased pressure in the skull will be transmitted to the back of the eye. Your vision will also be tested to see if you have abnormal blind spots.

Imaging tests

Your doctor may perform a CT or MRI scan of your brain to look for signs of spinal fluid pressure. These scans can also be used to check for other conditions that could be causing your symptoms, such as tumors or blood clots.

A CT scan combines several X-rays to make a cross-sectional image of your brain. An MRI scan uses magnetic waves to produce a highly detailed image of your brain.

Spinal tap

Your doctor may also perform a spinal tap, or lumbar puncture, to measure the pressure of your spinal fluid. This involves placing a needle between two bones, or vertebrae, in your back and drawing a fluid sample for testing.

Medications

Medications can help control or reduce the symptoms of pseudotumor cerebri. Your doctor might prescribe the following:

• Migraine medications can provide headache relief. These can include triptans like sumatriptan (Imitrex) and naratriptan (Amerge)
• Glaucoma drugs, such as acetazolamide (Diamox), cause your brain to produce less cerebrospinal fluid. These drugs can cause fatigue, kidney stones, nausea, and a tingling sensation in your mouth, toes, or fingers.
• Diuretics, such as furosemide (Lasix), make you urinate more often. This causes you to retain less fluid in your body, which helps ease the pressure in your skull. These may be used in combination with glaucoma drugs to make them more effective.

Surgery

Your doctor may recommend surgery if your vision becomes worse or if they need to drain excess cerebrospinal fluid.

• Optic nerve sheath fenestration: Optic nerve sheath fenestration involves cutting the membrane around your optic nerve to let extra fluid out. According to the Mayo Clinic, it’s successful at relieving symptoms more than 85 percent of the time.
• Spinal fluid shunt placement: A spinal fluid shunt procedure involves placing a thin tube in your brain or lower spine to drain extra fluid. The excess fluid is shunted away, typically to the abdominal cavity. This procedure is usually done only in severe cases. According to the Mayo Clinic, it has a success rate of more than 80 percent.

Other forms of treatment

Other treatment methods include losing weight and having multiple spinal taps performed to relieve pressure.

You’ll need to see your eye doctor regularly to have your vision checked once the pseudotumor cerebri is gone. Your eye doctor will watch you closely to make sure that you don’t continue to have vision changes that could result in permanent vision loss.

You should also let your primary care doctor know if you start having symptoms of this condition again.

Gaining weight puts you at a higher risk of having a pseudotumor cerebri. You can help prevent this condition by losing excess body weight and keeping it off. Switching to a healthy diet and getting regular exercise can help you drop the extra weight.

Your diet should include plenty of fruits, vegetables, and whole grains. You should also choose lean meats and dairy products that are low in fat. Limit or avoid eating foods that are high in:

• added sugars
• saturated fat
• trans fat
• sodium

Adopt a regular exercise routine, which can be as simple as walking. You can follow a more vigorous workout routine if your doctor says it’s safe to do so.