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Pseudotumor Cerebri, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Buildup of CSF pressure without mass lesion or clear etiology

  • Also known as idiopathic intracranial hypertension

  • 2 proposed mechanisms:

    • Increased abdominal pressure or intracranial veno...

Diagnosis

Signs and Symptoms

History

  • Headache:

    • Typically described as constant, bilateral

    • Pressure like

    • Worse in the morning

    • Worse with Valsalva maneuver

  • Nausea and vomiting

  • Tinnitus or pulsatile intracranial...

Treatment

Pre-Hospital

Pain control as appropriate 

Initial Stabilization/Therapy

  • Airway and circulation management as indicated

  • IV fluid hydration

Ed Treatment/Procedures

  • Large-volume lumbar puncture of 20...

Follow-Up

Disposition

Admission Criteria

Acute or impending visual loss 

Discharge Criteria

  • Consultation obtained from neurology and ophthalmology

  • Appropriate follow-up arranged

  • Tolerating oral diuretics

  • Pai...

Pearls and Pitfalls

  • Consider this diagnosis in younger patients with chronic headache

  • Consider measuring opening pressure when performing lumbar puncture for headache

  • Measure opening pressure with neck ...

Additional Reading

  • Bradley  WG, Daroff  R, Fenichel  G, et al., eds. Neurology in Clinical Practice. 5th ed. Philadelphia, PA: Butterworth-Heinemann, 2008.

  • Galgano  MA, Deshaies  EM. An update on the...

Codes

ICD9

348.2 Benign intracranial hypertension 

ICD10

G93.2 Benign intracranial hypertension 

SNOMED

  • 68267002 Benign intracranial hypertension (disorder)

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