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Neurology India 2021Rise in intracranial tension (ICT) has varied clinical presentation which can range from subtle disturbances like headache to frank neurologic impairment. An important...
Rise in intracranial tension (ICT) has varied clinical presentation which can range from subtle disturbances like headache to frank neurologic impairment. An important aspect is rapidity of rise of ICT. Pseudotumor cerebri is associated with many syndromes, toxication, and drugs. Our case is a unique one given the rarity of eltroxin, which is otherwise relatively safe drug and commonly used in this part of the world, induced Pseudotumor cerebri. Our patient had dramatic response to discontinuation of levothyroxine.
Topics: Headache; Humans; Pseudotumor Cerebri; Syndrome; Thyroxine
PubMed: 34747819
DOI: 10.4103/0028-3886.329602 -
JAAPA : Official Journal of the... May 2019Idiopathic intracranial hypertension is a rare disorder of elevated intracranial pressure with normal cerebrospinal fluid composition and without intracranial pathology.... (Review)
Review
Idiopathic intracranial hypertension is a rare disorder of elevated intracranial pressure with normal cerebrospinal fluid composition and without intracranial pathology. This condition primarily affects obese women of childbearing age and frequently causes headaches, vision loss, diplopia, tinnitus, and nausea. The incidence of idiopathic intracranial hypertension is rising along with obesity rates. Primary care and ED clinicians must recognize the signs and symptoms of idiopathic intracranial hypertension and intervene promptly to control symptoms and to preserve vision. This article reviews the clinical presentation and management of patients with idiopathic intracranial hypertension.
Topics: Headache; Humans; Incidence; Intracranial Pressure; Obesity; Pseudotumor Cerebri; Risk; Tinnitus; Vision Disorders
PubMed: 30969189
DOI: 10.1097/01.JAA.0000554732.85914.91 -
Neurosurgery Clinics of North America Apr 2022Idiopathic intracranial hypertension, pseudotumor cerebri, and benign intracranial hypertension are terms used to describe a neurologic syndrome characterized by... (Review)
Review
Idiopathic intracranial hypertension, pseudotumor cerebri, and benign intracranial hypertension are terms used to describe a neurologic syndrome characterized by elevated intracranial pressure, headache, vision loss, and absence of underlying mass lesion and infection. Increased cerebrospinal fluid (CSF) production has been proposed to play a role in this condition; however, in patients with CSF hypersecretion with known causes such as choroid plexus hyperplasia, patients often develop ventriculomegaly and hydrocephalus. Classically, pseudotumor cerebri is diagnosed as a triad of headache, visual changes, and papilledema. This article discusses the role of medical and surgical management and the expanding role of venous stenting.
Topics: Constriction, Pathologic; Humans; Hydrocephalus; Intracranial Hypertension; Pseudotumor Cerebri; Vision Disorders
PubMed: 35346452
DOI: 10.1016/j.nec.2021.11.002 -
Seminars in Ophthalmology 2017Pseudotumor cerebri syndrome refers to elevated intracranial pressure associated with papilledema without an identified etiology for intracranial hypertension. Over the... (Review)
Review
Pseudotumor cerebri syndrome refers to elevated intracranial pressure associated with papilledema without an identified etiology for intracranial hypertension. Over the past few decades, several medications have been described to be associated with this syndrome. We searched the literature for those case reports and series and evaluated the evidence for the association of such medications with pseudotumor cerebri syndrome.
Topics: Drug-Related Side Effects and Adverse Reactions; Humans; Intracranial Pressure; Papilledema; Pseudotumor Cerebri
PubMed: 27786584
DOI: 10.1080/08820538.2016.1228415 -
Current Neurology and Neuroscience... Mar 2020The goal of this review is to describe the presenting features of fulminant idiopathic intracranial hypertension (IIH) and outline the multimodal approach to its... (Review)
Review
PURPOSE OF REVIEW
The goal of this review is to describe the presenting features of fulminant idiopathic intracranial hypertension (IIH) and outline the multimodal approach to its treatment.
RECENT FINDINGS
Venous sinus stenting may be an appropriate alternative to optic nerve sheath fenestration or cerebrospinal fluid shunting in select patients with fulminant IIH. Prompt surgical intervention maximizes the chance of visual recovery in patients with fulminant IIH. "Fulminant IIH" is defined as intracranial hypertension with no secondary cause, severe vision loss within 4 weeks of symptom onset, and progressive vision loss over days. Rapid recognition of the fulminant phenotype of IIH by emergency department physicians, neurologists, and ophthalmologists is critical. Without appropriate triage and rapid medical and surgical intervention, patients with fulminant IIH are at high risk for profound, permanent vision loss. Prompt surgical intervention with optic nerve sheath fenestration, cerebrospinal fluid shunting, or venous sinus stenting minimizes the chance of poor visual outcome. If a delay is anticipated, serial lumbar punctures or temporary cerebrospinal fluid drainage and medical therapy may forestall irreversible vision loss.
Topics: Humans; Intracranial Hypertension; Neurosurgical Procedures; Pseudotumor Cerebri; Ventriculoperitoneal Shunt; Vision Disorders
PubMed: 32219578
DOI: 10.1007/s11910-020-1026-8 -
Neurosurgery Clinics of North America Jul 2024Idiopathic intracranial hypertension is defined by headaches and a decline in visual acuity due to increased intracranial pressure. Treatment options historically...
Idiopathic intracranial hypertension is defined by headaches and a decline in visual acuity due to increased intracranial pressure. Treatment options historically included weight loss, acetazolamide, and/or cerebrospinal fluid diversion surgery. Recent understanding of the contributions of dural venous sinus hypertension and stenosis has led to venous sinus stenting as a treatment option.
Topics: Humans; Acetazolamide; Cranial Sinuses; Intracranial Hypertension; Pseudotumor Cerebri; Stents
PubMed: 38782521
DOI: 10.1016/j.nec.2024.02.001 -
Journal of Neuro-ophthalmology : the... Sep 2017Idiopathic intracranial hypertension, otherwise known as primary pseudotumor cerebri syndrome (PTCS), most frequently occurs in obese women of childbearing age. However,... (Review)
Review
Idiopathic intracranial hypertension, otherwise known as primary pseudotumor cerebri syndrome (PTCS), most frequently occurs in obese women of childbearing age. However, children may be affected as well. This review will address recent findings regarding demographics, diagnosis, and treatment of pediatric PTCS. Prepubertal children with primary PTCS have an equal sex distribution and less frequent obesity compared with adult patients. However, female gender and obesity are risk factors for primary PTCS in postpubertal children. Compared with adults, children with PTCS more frequently present with ocular motility deficits and more often have associated medical conditions that increase the risk of developing PTCS. Visual field testing may be unreliable, and the optimal modality to monitor visual function is unknown. MRI shows signs of elevated intracranial pressure (ICP) in children with PTCS similar to that of adults. It has now been established that elevated ICP in children ≤18 years old is greater than 25 cm H20 in nonobese, nonsedated children, and greater than 28 cm H2O in the remainder. Optical coherence tomography (OCT) may be used to distinguish pseudopapilledema from papilledema, monitor response to treatment in preverbal children, and identify patients with PTCS at risk for permanent visual loss. However, the precise role of OCT in the management of pediatric PTCS remains to be determined.
Topics: Child; Diagnosis, Differential; Eye Diseases, Hereditary; Humans; Intracranial Pressure; Optic Disk; Optic Nerve Diseases; Pseudotumor Cerebri; Syndrome; Tomography, Optical Coherence
PubMed: 28806347
DOI: 10.1097/WNO.0000000000000548 -
Journal of Neurology Dec 2015This review summarizes topical papers from the fields of neuro-ophthalmology and neuro-otology published from August 2013 to February 2015. The main findings are: (1)... (Review)
Review
This review summarizes topical papers from the fields of neuro-ophthalmology and neuro-otology published from August 2013 to February 2015. The main findings are: (1) diagnostic criteria for pseudotumor cerebri have been updated, and the Idiopathic Intracranial Hypertension Treatment Trial evaluated the efficacy of acetazolamide in patients with mild vision loss, (2) categorization of vestibular disorders through history and ocular motor examination is particularly important in the acute vestibular syndrome, where timely distinction between a central or peripheral localization is essential, (3) the newly described "sagging eye syndrome" provides a mechanical explanation for an isolated esodeviation that increases at distance in the aging population and (4) eye movement recordings better define how cerebellar dysfunction and/or sixth nerve palsy may play a role in other patients with esodeviations that increase at distance.
Topics: Adult; Child; Esotropia; Humans; Neurotology; Ophthalmology; Pseudotumor Cerebri; Vestibular Diseases
PubMed: 26122540
DOI: 10.1007/s00415-015-7825-1 -
Der Nervenarzt Feb 2017This review describes the clinical findings as well as thes diagnostic and therapeutic options for idiopathic intracranial hypertension (pseudotumor cerebri).... (Review)
Review
This review describes the clinical findings as well as thes diagnostic and therapeutic options for idiopathic intracranial hypertension (pseudotumor cerebri). Furthermore, the pathophysiological concepts are discussed. Idiopathic intracranial hypertension is characterized by signs and symptoms of raised intracranial pressure with no established pathogenesis. Common symptoms include headaches, visual loss and pulsatile tinnitus. Treatment has two major goals: the alleviation of headaches and the preservation of vision. Weight loss and acetazolamide are the cornerstones in the treatment of the disorder. Drainage of cerebrospinal fluid, optic nerve sheath fenestration and stent angioplasty of a sinus stenosis can be employed in severe cases.
Topics: Acetazolamide; Blindness; Combined Modality Therapy; Diagnosis, Differential; Diet Therapy; Evidence-Based Medicine; Headache; Humans; Pseudotumor Cerebri; Symptom Assessment; Tinnitus
PubMed: 28083688
DOI: 10.1007/s00115-016-0279-6 -
Current Pain and Headache Reports May 2024Rebound intracranial hypertension (RIH) is a post-procedural treatment complication in patients with spontaneous intracranial hypotension (SIH) characterized by... (Review)
Review
PURPOSE OF REVIEW
Rebound intracranial hypertension (RIH) is a post-procedural treatment complication in patients with spontaneous intracranial hypotension (SIH) characterized by transient high-pressure headache symptoms. This article reviews the epidemiology, clinical features, risk factors, and treatment options for RIH.
RECENT FINDINGS
This article discusses how changes in underlying venous pressure and craniospinal elastance can explain symptoms of RIH, idiopathic intracranial hypertension (IIH), and SIH. The pathophysiology of RIH provides a clue for how high and low intracranial pressure disorders, such as IIH and SIH, are connected on a shared spectrum.
Topics: Humans; Intracranial Hypertension; Intracranial Hypotension; Risk Factors; Pseudotumor Cerebri; Headache
PubMed: 38430310
DOI: 10.1007/s11916-024-01231-9