Pseudotumour Cerebri Syndrome in China: A Cohort Study

Qian Chen,Chaoyi Feng,Yan Sha,Zhenxin Li,Guohong Tian,Min Wang,Weimin Chen,Xinghuai Sun,Guixian Zhao

doi:10.1038/s41598-020-58080-w

Abstract

Pseudotumour cerebri syndrome (PTCS) remains to be fully investigated in Chinese patients and our study reported PTCS-related clinical differences between Chinese patients and Western patients. This study enrolled 55 consecutive patients (females: 44, median age: 37 y, age range: 14–62 y) with PTCS diagnosed from October 2015 to December 2017. Nine (16.4%, females) patients had primary PTCS, and 46 (83.6%) had secondary PTCS (P = 0.001). At presentation, 81.8% of patients had grade >3 papilloedema, with 23.6% having diffusely constricted fields. Mean subarachnoid space around the optic nerve measured by retrobulbar ultrasonography during lumbar puncture was 1.12 ± 0.17 mm and decreased to 0.86 ± 0.11 mm after treatment. Optical coherence tomography (OCT) showed that 92.9% of eyes with intact macular ganglion cell-inner plexiform layer (GCIPL) at baseline had good outcomes after treatment. Patients’ demographic and clinical characteristics showed that secondary PTCS was more common than primary idiopathic intracranial hypertension in Chinese patients. Polycystic ovarian syndrome was the main associated factor in females. Poor visual function was common at presentation. Noninvasive ocular ultrasonography and OCT are the prognostic indicators of PTCS treatment in intracranial pressure and visual function, respectively, after PTCS treatment.

Highlights

Pseudotumour cerebri syndrome (PTCS), proposed by Friedman et al.[1] in 2013 describes increased intracranial pressure (ICP) of unknown cause
This study aimed to evaluate a cohort of consecutive Chinese patients with PTCS diagnosed at a tertiary ophthalmology hospital in Shanghai during a 2-year period who presented with various visual symptoms
(16.36%) patients with unknown underlying aetiology were diagnosed with primary PTCS, and the remaining 46 (83.64%) patients with underlying causes were diagnosed with secondary PTCS (P = 0.001)

Summary

Introduction

Pseudotumour cerebri syndrome (PTCS), proposed by Friedman et al.[1] in 2013 describes increased intracranial pressure (ICP) of unknown cause. The term idiopathic intracranial hypertension (IIH) is assigned to patients with primary PTCS, and is predominant in women of childbearing age with obesity[2,3,4]. The term PTCS is used because of its atypical presentation (male, non-obese, associated medical conditions) in many Chinese patients. This study aimed to evaluate a cohort of consecutive Chinese patients with PTCS diagnosed at a tertiary ophthalmology hospital in Shanghai during a 2-year period who presented with various visual symptoms. The goals included both analysing patients’ demographic and clinical characteristics, and finding prognostic indicators of treatment

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Results

Conclusion