Pseudotumor Cerebri(PTC)/ Idiopathic Intra-Cranial Hypertension(IIH)

Pseudotumor Cerebri (PTC), also known as Idiopathic Intracranial Hypertension (IIH), is a condition characterized by increased intracranial pressure without a detectable tumor or other cause.

Symptoms: 1. Headaches (severe, frequent) 2. Vision changes (double vision, blurred vision) 3. Tinnitus (ringing in ears) 4. Hearing loss 5. Dizziness 6. Nausea and vomiting 7. Papilledema (swelling of optic disc)

Causes and risk factors: 1. Obesity 2. Female gender (especially childbearing age) 3. Hormonal changes 4. Certain medications (e.g., tetracyclines, vitamin A derivatives) 5. Sleep apnea 6. Head trauma

Diagnosis: 1. Lumbar puncture (LP) to measure cerebrospinal fluid (CSF) pressure 2. Imaging studies (MRI, CT scans) to rule out other causes 3. MR venogram or CT venogram of the head can be done to rule out a cerebral venous sinus thrombosis. A lumbar puncture (spinal tap) is done to measure the pressure of the cerebrospinal fluid unless something is seen on the MRI or CT scan indicating a spinal tap is not safe procedure.

4. Optic Nerve evaluation for papilledema

Treatment: 1. Weight loss and lifestyle modifications 2. Medications: - Carbonic anhydrase inhibitors (e.g., acetazolamide) - Corticosteroids - Diuretics 3. Lumbar punctures (therapeutic) 4. Shunting procedures (in severe cases)

Complications: 1. Vision loss 2. Hearing loss 3. Chronic headaches 4. Cognitive impairment 5. Depression and anxiety

Monitoring: 1. Regular Eye exams 2. Imaging studies 3. LP to assess CSF pressure

https://www.youtube.com/watch?v=tPJxGkF6JeU

Author

Paddy Kalish OD, JD and B.Arch

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