Pathophysiology
1) intracranial hypertension in absence of another lesion or mass 2) diagnosis is largely one of exclusion
Signs and Symptoms
1) headache 2) transient visual distortions 3) focal central blindness 4) loss or peripheral vision
Characteristic Test Findings
Lumbar puncture – 1) normal CSF 2) increased opening pressure Funduscopic exam – 3) papilledema
Associated Conditions
increased incidence with – 1) lupus 2) exposure to glucocorticoids and mineralocorticoids 3) large amounts of vitamin A 4) amiodarone 5) oral contraceptives 6) tetracycline
Biochemistry
likely related to impaired CSF absorption by arachnoid villi
Inheritance/Epidemiology
typical patient is young, female, and obese
Treatment
acetazolamide (carbonic anhydrase inhibitor) to reduce CSF production
Tips for USMLE
if an overweight 25 year-old woman has been trying a carrot-only diet to lose weight and develops headache and loss of peripheral vision and on physical exam has no fever and no nuchal rigidity, but does have moderate swelling of the optic disc, and whose test workup shows a negative CT and MRI scan of the brain, a normal CBC, a normal sed rate, and a normal CSF except for a moderately increased opening pressure, think pseudotumor cerebri
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