Pseudotumor Cerebri

Idiopathic Intracranial hypertension (IIH)

Idiopathic intracranial hypertension (IIH)= pseudotumor cerebri = benign intracranial hypertension (BIH)

obese woman of child bearing age (premenopausal) with headache, papilledema, pulsatile tinnitus, diplopia (2°sixth cranial nerve palsy) and transient vision loss

Etiology:

• some anti- acne actually cause BIH such as teteracycline, Vitamin A and drugs that can precipitate acne formation such as steroid also lead to BIH!!

Others: OCPs, minocycline, cimetidine, danazol, tamoxifen, levothyroxine, lithium, nitrofurantoin

Endocrine disorders (addison's disease, hypoparathyroidism, hypothyroidism, Cushing disease); chronic lung disease

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C: COCP.

R: Retinoids (isotretinoin, tretinoin); Vitamin A.

L: Lithium

T: Tetracycline (& minocycline), tamoxifen, T4

S: Steroids.

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DDx include

'Saggital sinus thrombosis' (reason - young female; autoimmune ; on OCPs)

Dx

Features

• headache
• blurred vision
• papilloedema (usually present)
• enlarged blind spot
• sixth nerve palsy may be present

Assessment criteria (diagnosis of exclusion):

1. an awake and alert patient