Question

Pseudotumor Cerebri

What is the treatment for pseudotumor cerebri?

A Answers (5)

  • Treatment options for pseudotumor cerebri include medications that treat migraines and glaucoma and can help treat symptoms. Diuretics may help relieve pressure. Surgery in order to physically relieve intracranial pressure is also an option. This can include a spinal fluid shunt or an optic nerve sheath fenestration. Weight loss and restrictions on salt and fluid also provide treatment for pseudotumor cerebri.

  • Obesity, other treatable diseases, and some medications can cause raised intracranial pressure and symptoms of pseudotumor cerebri. A thorough medical history and physical examination is needed to evaluate these factors. If a diagnosis of pseudotumor cerebri is confirmed, close, repeated ophthalmologic exams are required to monitor any changes in vision. Drugs may be used to reduce fluid buildup and relieve pressure. Weight loss and cessation of certain drugs (including oral contraceptives, tetracycline, and a variety of steroids) may lead to improvement. Surgery may be needed to remove pressure on the optic nerve. Therapeutic shunting, which involves surgically inserting a tube to drain CSF from the lower spine into the abdominal cavity, may be needed to remove excess CSF and relieve CSF pressure.

    This answer is based on source information from the National Institute of Neurological Disorders and Strokes.

  • ASteven Meyers, MD, Neurology, answered on behalf of NorthShore University HealthSystem
    In mild cases, no treatment may be necessary. Weight loss and avoiding any medications that may have precipitated the disease may be sufficient. Lumbar puncture to withdraw cerebrospinal fluid can lower the intracranial pressure and sometimes cures the condition. Certain medications can also lower the pressure by reducing fluid production. Less commonly surgical treatment by inserting a shunt to continously withdraw cerebrospinal fluid may be necessary.
  • If you have no significant headaches or evidence of vision loss (including visual fields), no treatment may be necessary. If you do experience these problems, however, certain medications used in treating glaucoma (such as acetazolamide) can lower the CSF pressure in the head by reducing production of this fluid. Diuretics may also be prescribed. One of the most effective treatments is weight reduction in overweight patients. Pressure may also be lowered by draining off CSF through repeated spinal taps.

    Repeat visual field testing is essential in following patients with PTC. If your visual field is worsening or you experience a decrease in central vision, and you do not have severe headaches, a small hole or multiple slits may be placed in the optic nerve sheath (called optic nerve sheath fenestration) just behind the eye using an operating microscope. This is done to protect the optic nerve from further damage. If severe headaches accompany visual loss, a shunting procedure (lumbo-peritoneal or ventriculo-peritoneal) may be required, in which a small tube is placed to carry fluid from where it is building up to where it can be absorbed, thus relieving pressure.

  • AAlan J Margolis, MD, Ophthalmology, answered on behalf of MDLIVE
    Pseudotumor cerebri is a condition which often affects young people with symptoms such as headaches, double vision, and decreased vision.  In this condition, there is often increased pressure within the brain. This can be measured with a spinal tap. Imaging studies of the brain often show no abnormalities in these individuals. The treatment of this condition includes measures designed to decrease the intracranial pressure in affected individuals. Treatments include placement of shunting devices and use of oral medications such as Acetazolamide to help lower intracranial pressure. 
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How is a lumbar puncture used in treating pseudotumor cerebri?