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Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)

Jessica T. Servey, MD, MHPE, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Increased intracranial pressure with no clear pathophysiology

  • Many have suggested calling it pseudotumor cerebri syndrome emphasizing the variety of subtypes (1).

  • Subtypes include true...

DIAGNOSIS

HISTORY

  • Most frequent symptom (and most frequent presenting symptom) is headache. This occurs in 84–94% of patients. 51% have constant or daily headaches). These headaches are severe and have...

TREATMENT

GENERAL MEASURES

  • Weight loss is key and always recommended as adjunct to medications.

  • Study using low-calorie diet and weight loss up to 15 kg demonstrated improvements in symptoms, papilledem...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Recommend frequent ophthalmologic or neuro-ophthalmologic follow-up. 

Patient Monitoring

Funduscopic exams, visual fields, and retinal thickness monitored regularly...

REFERENCES

1
Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology.  2013;81(13):1159–1165. [View Abstract on OvidMedlin...

ADDITIONAL READING

  • McGeeney BE, Friedman DI. Pseudotumor cerebri pathophysiology. Headache.  2014;54(3):445–458. [View Abstract on OvidMedline]

  • Sugerman HJ, Felton WLIII, Sismanis A, et al. Gastri...

CODES

ICD10

G93.2 Benign intracranial hypertension 

ICD9

348.2 Benign intracranial hypertension 

SNOMED

68267002 Benign intracranial hypertension (disorder) 

CLINICAL PEARLS

  • Highest incidence in obese women

  • Headache and visual disturbance are most frequent symptoms.

  • Diagnosis made by lumbar puncture, ophthalmologic exam, and MRI; no lab testing needed

  • Weight ...

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