Intracranial Idiopathic Hypertension (Pseudotumor Cerebri)

Pseudotumor Cerebri is caused by elevated cerebrospinal fluid in the brain.  It is most commonly seen in overweight individuals, and can accompany pregnancy.  Early diagnosis is important as it can affect Cranial Nerve II, or the optic nerve, and can produce changes in vision that can become permanent if not treated appropriately.  This is often seen during an evaluation of the retina to determine if papillidema, or swelling is occuring of the optic nerve.

Symptoms

• Dull ache at the base of the skull
• Temporary visual changes or periods of blindness
• Double vision

Causes

• Weight gain
• Pregnancy
• Certain classes of medications (antiobiotic tetracycline, steroids, vitamin A)
• narrowing of blood vessels that typically drain blood from the brain (congenital, or from birth)

Diagnosis

Diagnosis occurs via opthalmic examination to determine papilledema, or swelling of the optic nerve.  CT and/or MRI will ensure that there isn't a brain tumor associated, and may diagnose smaller diameter blood vessels.  Lumbar puncture, or spinal tap, will be the final determining factor, and patients will often feel a temporary relief of symptoms.  Further evaluation of eye fields is important to determine risk of visual loss.  

Treatment

Weight loss is the most effective long-term management of this condition.  Chiropractic Neurology can aid in the improvement of posture and reduction of muscle and joint strain that occurs as the spinal mechanics change with weight gain and head forward posture, increasing cephalic (head) pressure.  Surgical options are sometimes warranted to create a shunt to drain fluid, or cut the sheath that surrounds the optic nerve to prevent visual loss.