Pseudotumor Cerebri – Symptoms and Causes
What to Know About Pseudotumor Cerebri
Pseudotumor cerebri happens when pressure builds up inside the skull for no clear reason. The brain shows signs similar to a tumor, but no actual tumor exists. This condition is also called idiopathic intracranial hypertension.
It is considered rare, affecting about 1 in 100,000 people, but is more commonly seen in certain groups. Prompt recognition is important to reduce the risk of complications, especially those related to vision.
Symptoms
Pseudotumor cerebri often causes symptoms that mimic those of a brain tumor, even though no tumor is present.
The most common symptom is a persistent, throbbing headache that typically affects the entire head. This headache may worsen with eye movement or when lying down.
Vision problems frequently occur and should not be ignored. These can include brief episodes of blindness, difficulty seeing to the side, double vision, or blurred vision.
Many people also experience a “whooshing” sound in the ears that pulses with heartbeat (called pulsatile tinnitus).
Physical examination often reveals swelling of the optic nerve (papilledema) when a doctor examines the back of the eye. Additional symptoms may include:
- Nausea and vomiting
- Dizziness or vertigo
- Neck, shoulder, or back pain
- Light sensitivity (photophobia)
- Pain behind the eyes
During physical examination, doctors may detect papilledema (swelling of the optic nerve) when examining the eyes. Symptoms can develop gradually over weeks or appear suddenly.
Causes
Pseudotumor cerebri develops when pressure inside the skull increases without a detectable cause, such as a tumor or mass. Research suggests that a disruption in the normal drainage of cerebrospinal fluid (CSF) is likely involved.
The brain continuously produces CSF, which cushions the brain and spinal cord. When this fluid doesn’t drain or absorb properly, it can build up and increase pressure within the skull, resulting in symptoms that resemble those of a brain tumor.
Risk Factors
Several factors can increase a person’s chance of developing pseudotumor cerebri. Obesity stands as the main risk factor, especially for women of childbearing age.
People with a body mass index (BMI) in the obese range face a much higher risk than those with normal weight.
Women develop this condition more often than men. The condition most commonly affects women between ages 20 and 50. Recent weight gain can trigger the condition, even in people who aren’t significantly overweight.
Certain medications may increase the risk, including:
- Tetracycline antibiotics
- Growth hormone treatments
- Some steroids (particularly when starting or stopping them)
- Excess vitamin A or retinol supplements
- Certain birth control pills
Medical conditions linked to a higher risk include:
- Sleep apnea
- Kidney disease
- Addison’s disease
- Lupus
- Uremia
- Anemia
Family history may play a role for some people, suggesting possible genetic factors. People with narrow or irregular skull formations might also face an increased risk.
Complications
Pseudotumor cerebri, also known as idiopathic intracranial hypertension, can lead to several serious complications if not treated properly. The most concerning complication is vision loss.
The increased pressure inside the skull puts strain on the optic nerve, which can damage nerve fibers and cause permanent vision problems.
This vision loss may begin as blind spots and gradually worsen to severe vision impairment or even blindness in some cases.
Many patients experience persistent headaches that don’t respond well to regular pain medications. These headaches can become chronic and significantly affect daily life.
The pain is often described as throbbing or pressure-like and may worsen with eye movement or when lying down.
Depression and anxiety commonly develop in people with pseudotumor cerebri. The combination of chronic pain, vision problems, and lifestyle limitations can take a toll on mental health. These psychological complications may require separate treatment alongside the primary condition.
Some patients develop papilledema (swelling of the optic nerve) that can persist even after pressure is reduced. This ongoing swelling may contribute to progressive vision damage even when other symptoms improve.
Treatment complications can also occur. Long-term use of medications like acetazolamide may cause side effects including tingling in the hands and feet, kidney stones, fatigue, and taste alterations.
Surgical procedures used to treat severe cases carry risks of infection, bleeding, and cerebrospinal fluid leakage.
People with pseudotumor cerebri often face challenges maintaining work and daily activities due to unpredictable symptoms. This can lead to financial strain and decreased quality of life.
