Pseudotumor Cerebri

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Pseudotumor cerebri, also known as idiopathic intracranial hypertension (IIH), is a condition in which the pressure inside the skull is too high.

The condition affects women more than men and is often associated with obesity. It tends to occur in patients in their 40s and 50s. Patients with CSF rhinorrhea, CSF otorrhea, or nasal meningoceles/encephaloceles may also have pseudotumor cerebri.

Pseudotumor Cerebri Symptoms

Patients suffering from this disorder can experience:

  • Headaches
  • Loss of vision
  • Dizziness
  • Hearing loss
  • Tinnitus (ringing in the ears)

Headaches are often severe and occur in over 90 percent of patients with pseudotumor cerebri.

Pseudotumor Cerebri Diagnosis

Patients often need multiple tests to rule out other causes of their symptoms, including meningitis, obstructive hydrocephalus, tumors and blockage of the veins that drain blood away from the brain. 

Diagnosis begins with a careful history and physical exam. Patients may need to see multiple health care providers, including neurologists, neurosurgeons, otolaryngologists (ear, nose and throat specialists) and ophthalmologists.

Tests for the condition may include:

  • Eye exam to test for vision loss and papilledema, which occurs when a portion of back of the eye becomes swollen
  • Hearing test to look for any other cause of tinnitus
  • MRI of the brain to look at the size of the ventricles and look for other signs of pseudotumor like empty sella (a condition where the pituitary gland shrinks or is flattened)
  • Lumbar puncture (spinal tap) to measure the brain and spinal fluid pressure and check for the presence of bacteria or viruses and rule out meningitis

Treating Pseudotumor Cerebri at UVA

You may need surgery is your symptoms don’t respond to medication.

While usually surgery includes placing shunts to drain off the extra fluid into the abdominal cavity, doctors at UVA have found great success with stenting.

Pseudotumor Cerebri Relief

Read how one patient found relief with this stenting procedure.

Other treatment options aim to reduce major symptoms, including headaches and vision loss. Weight loss and a low-sodium diet can control blood pressure and reduce symptoms.

Medication for Pseudotumor Cerebri Relief

Some medications that help decrease the production of the fluid that surrounds the brain (cerebrospinal fluid or CSF) include:

  • Acetazolamide, a carbonic anhydrase inhibitor
  • Diuretics (water pills), such as furosemide
  • Steroids, such as prednisone (needed in some cases where vision loss happened quickly)


Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.