Pseudotumor cerebri (PTC) is a condition in which the pressure from the cerebral spinal fluid inside your head is elevated. This can cause problems such as headaches, blurred vision, or loss of vision. The condition is known as pseudotumor cerebri because symptoms can mimic those of an intracranial tumor.

The cerebral spinal fluid (CSF) is a clear fluid that bathes the brain and spinal cord. In cases of PTC, this fluid is blocked from flowing back from the head as it should, leading to high CSF pressure inside the head. The pressure swells the optic disc at the back of the eye, which can damage (sometimes permanently) the optic nerve and cause vision loss. It can also damage the nerves that control eye movement, resulting in double vision.

The causes of PTC are not certain, but they may include the following:

  • hormonal influences, in young women;
  • antibiotics;
  • steroids; and
  • high doses of vitamin A.

The most common symptoms of PTC are headache and visual loss. The headache can be located anywhere, but is usually in the back of the head. It may wake you in the middle of the night, and it may worsen with bending or stooping. Other symptoms include:

  • dimming, blurring, or graying of vision;
  • difficulty seeing to the side;
  • brief visual disturbances;
  • double vision;
  • rushing noise in the ears; and
  • nausea and vomiting.

Your ophthalmologist (Eye M.D.) will give you a complete eye examination. It may be necessary for you to have an MRI scan and spinal tap to assure accurate diagnosis and to rule out other CSF abnormalities.

If your symptoms are mild, no treatment other than careful monitoring may be necessary. If you require treatment, certain glaucoma medications and diuretics can help lower CSF pressure. Weight loss is an effective treatment in overweight patients. Pressure can also be lowered by draining CSF through repeated spinal taps.

If your vision continues to deteriorate after you have begun treatment, surgical techniques may be required to protect the optic nerve from any further damage.

(c) 2007 The American Academy of Ophthalmology

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