Pseudotumor Cerebri: Brief Review of Clinical Syndrome and Imaging Findings

A.J Degnan,L.M Levy

doi:10.3174/ajnr.a2404

Abstract

PTC is a clinical entity of uncertain etiology characterized by intracranial hypertension. The syndrome classically manifests with headaches and visual changes in women with obesity. Traditionally, imaging ruled out secondary causes of elevated CSF pressure but now may reveal findings frequently seen in patients with PTC, including the following: flattening of the globe, an empty sella, an enlarged ONS, protrusion and enhancement of the optic nerve head, and increased tortuosity of the optic nerve. Novel imaging methods, including MR venography, have additionally identified sinovenous stenosis as a potential indicator of PTC.

Highlights

The fact that most cases of PTC spontaneously resolve and that most treatment studies lack control groups limits our interpretation of outcome measures reported for many treatment modalities.[45] Conservative measures are typically recommended in patients without vision changes as the predominant presentation and consist of weight loss and medication.[20] These conservative approaches may take time to take effect; as a result, frequent follow-up, including formal visual field testing at intervals of 1 month, 3 months, and every 3– 6 months, is advisable.[20]
Intracranial hypertension is a clinical entity with a myriad of known and putative etiologies
Heinrich Quincke, an early pioneer in the use of lumbar puncture, reported the first recorded cases of intracranial hypertension of unknown cause in what he described as “meningitis serosa” in 1893; at that time, he posited that inadequate CSF resorption was responsible for the syndrome, a theory that is still entertained by some researchers.[2]

Summary

Introduction

The fact that most cases of PTC spontaneously resolve and that most treatment studies lack control groups limits our interpretation of outcome measures reported for many treatment modalities.[45] Conservative measures are typically recommended in patients without vision changes as the predominant presentation and consist of weight loss and medication.[20] These conservative approaches may take time to take effect; as a result, frequent follow-up, including formal visual field testing at intervals of 1 month, 3 months, and every 3– 6 months, is advisable.[20]

Results

Conclusion