About the cover illustration

Abstract

Ocular Findings In Pseudotumor CerebriAs its colorful name suggests, pseudotumor cerebri is a syndrome in which the clinical findings may mimic the presence of an intracranial mass lesion. Headache and visual disturbances are common presenting complaints; physical findings may include retinal venous engorgement and prominence of the retinal disk that may be severe enough to resemble papilledema. Evaluation of such patients then yields further evidence of intracranial hypertension, but no mass lesion and no hydrocephalus. A number of drugs are known to cause this syndrome on occasion, but for many patients no cause is found. For them, the alternative syndrome name of benign idiopathic intracranial hypertension is particularly apt.Although the syndrome is indeed idiopathic, a number of hypotheses have been put forth. One derives from some of the occasional clinical associations: pregnancy, post-partum period, estrogen use. Because these are circumstances that increase the risk of thrombosis\Mespecially for people with underlying thrombophilic disorders—one might speculate that microvascular thrombotic events play a role. A paper in this month's issue of the Journal explores this possibility a bit, by looking for and finding an increased incidence of certain procoagulant states on patients with benign intracranial hypertension.This month's cover picture depicts the retinal findings in a patient with pseudotumor cerebri. The optic disk may be seen to be much more prominent than in the usual retina, with a larger venous caliber. The image may be viewed in color on the Journal's website: http://www.mosby.com/lab. The image was prepared by Pat Stanaitis Harvey, CRA, of the University of Minnesota; we thank her and Drs Eric Steuer and Jonathan Wirtschafter for making it available for our use. Ocular Findings In Pseudotumor CerebriAs its colorful name suggests, pseudotumor cerebri is a syndrome in which the clinical findings may mimic the presence of an intracranial mass lesion. Headache and visual disturbances are common presenting complaints; physical findings may include retinal venous engorgement and prominence of the retinal disk that may be severe enough to resemble papilledema. Evaluation of such patients then yields further evidence of intracranial hypertension, but no mass lesion and no hydrocephalus. A number of drugs are known to cause this syndrome on occasion, but for many patients no cause is found. For them, the alternative syndrome name of benign idiopathic intracranial hypertension is particularly apt.Although the syndrome is indeed idiopathic, a number of hypotheses have been put forth. One derives from some of the occasional clinical associations: pregnancy, post-partum period, estrogen use. Because these are circumstances that increase the risk of thrombosis\Mespecially for people with underlying thrombophilic disorders—one might speculate that microvascular thrombotic events play a role. A paper in this month's issue of the Journal explores this possibility a bit, by looking for and finding an increased incidence of certain procoagulant states on patients with benign intracranial hypertension.This month's cover picture depicts the retinal findings in a patient with pseudotumor cerebri. The optic disk may be seen to be much more prominent than in the usual retina, with a larger venous caliber. The image may be viewed in color on the Journal's website: http://www.mosby.com/lab. The image was prepared by Pat Stanaitis Harvey, CRA, of the University of Minnesota; we thank her and Drs Eric Steuer and Jonathan Wirtschafter for making it available for our use. As its colorful name suggests, pseudotumor cerebri is a syndrome in which the clinical findings may mimic the presence of an intracranial mass lesion. Headache and visual disturbances are common presenting complaints; physical findings may include retinal venous engorgement and prominence of the retinal disk that may be severe enough to resemble papilledema. Evaluation of such patients then yields further evidence of intracranial hypertension, but no mass lesion and no hydrocephalus. A number of drugs are known to cause this syndrome on occasion, but for many patients no cause is found. For them, the alternative syndrome name of benign idiopathic intracranial hypertension is particularly apt. Although the syndrome is indeed idiopathic, a number of hypotheses have been put forth. One derives from some of the occasional clinical associations: pregnancy, post-partum period, estrogen use. Because these are circumstances that increase the risk of thrombosis\Mespecially for people with underlying thrombophilic disorders—one might speculate that microvascular thrombotic events play a role. A paper in this month's issue of the Journal explores this possibility a bit, by looking for and finding an increased incidence of certain procoagulant states on patients with benign intracranial hypertension. This month's cover picture depicts the retinal findings in a patient with pseudotumor cerebri. The optic disk may be seen to be much more prominent than in the usual retina, with a larger venous caliber. The image may be viewed in color on the Journal's website: http://www.mosby.com/lab. The image was prepared by Pat Stanaitis Harvey, CRA, of the University of Minnesota; we thank her and Drs Eric Steuer and Jonathan Wirtschafter for making it available for our use.