Pseudotumor Cerebri

Written by Amanda Delgado | Published on July 9, 2012
Medically Reviewed by George Krucik, MD

What Is Pseudotumor Cerebri?

Pseudotumor cerebri is a condition in which the pressure around your brain increases, causing headaches and vision problems. The name means “false brain tumor,” since its symptoms are similar to those caused by brain tumors. It’s also known as idiopathic intracranial hypertension. It mainly affects women who are between 20 and 50 years old. This condition is treatable, although it can return in some cases.

What Causes Pseudotumor Cerebri?

The exact cause of this condition is unknown, though 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.

What Are the Risk Factors for Pseudotumor Cerebri?

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 obese women who are under 44 years old than in the general population (Mayo Clinic, 2012).

Medications

Certain medications may make you more susceptible to this condition. These include birth control pills, excessive amounts of vitamin A, and steroids (when you stop using them).

Other Health Conditions

Health conditions associated with pseudotumor cerebri include:

• kidney disease

• sleep apnea, abnormal breathing during sleep that wakes you from sleeping

• Addison’s disease, a disorder where the adrenal glands don’t produce enough hormones

Lyme disease, a chronic flu-like disease caused by a bacteria carried by ticks

A Birth Defect

Being born with stenosis, or narrowing, in two of the blood vessels in your brain may make you more likely to develop pseudotumor cerebri. The narrowed veins make it more difficult for fluid to move through your brain.

What Are the Symptoms of Pseudotumor Cerebri?

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. 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

How Is Pseudotumor Cerebri Diagnosed?

Eye Exam

Your doctor will check for swelling in the optic nerve at the back of your 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, or computed tomography scan, combines several X-rays to make a cross-sectional image of your brain. An MRI, or magnetic resonance imaging scan, uses radio waves and magnets 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.

What Are the Treatments for Pseudotumor Cerebri?

Medications

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

  • migraine medications to provide headache relief, such as tryptans like sumatriptan (Imitrex) and naratriptan (Amerge)
  • glaucoma drugs, such as acetazolamide, which 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, to 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 to drain excess cerebrospinal fluid. Surgical procedures include:

  • optic nerve sheath fenestration, which 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 (Mayo Clinic, 2012).
  • spinal fluid shunt, which involves placing a thin tube in your brain or lower spine to drain extra fluid. This procedure is usually done only in severe cases. According to the Mayo Clinic, it has a success rate of more than 80 percent (Mayo Clinic, 2012).

Other Forms of Treatment

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

Post-Treatment Outlook for Pseudotumor Cerebri

You’ll need to see your eye doctor regularly to have your vision checked once 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 experiencing symptoms of this condition again. The National Institutes of Health state that symptoms return in about 10 to 20 percent of people who have had pseudotumor cerebri (NIH).

Can Pseudotumor Cerebri Be Prevented?

Gaining weight puts you at a higher risk of having 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, and sodium. Adopt a regular exercise routine. This can be as simple as walking, or you can follow a more vigorous workout routine if your doctor says it’s safe to do so.

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