A False Tumor
A pseudotumor cerebri give the effect of a brain tumor, but it is not one. It causes pressure within the skull just like a tumor would but there is no sign of infection or any other cause. There can be symptoms like a headache, double vision, dizziness, total or partial vision loss and a buzzing sound in the ears, but no tumor. Sometimes a lumbar puncture will release pressure and thus preventing trouble with the eyes. Other treatments can be shunting to relieve pressure because of the retention of spinal fluid, medication and salt or fluid restrictions.
The cause is not clear but it is seen most often in women than men and these women are usually obese and premenopausal. There are a list of medications that are thought to increase your risk for this condition. Steroids, whether you are just starting to take them or are just stopping, Lithium, birth control pills, Phenytoin, Sulfa drugs, Tamoxifen, Nitrofurantoin and Minocycline. As your doctor does a physical exam to look for signs, he might find swelling at the back of the eyes, a head size that is larger then normal and babies whose cranial sutures have not closed will have a bulging anterior fontanelle. Your doctor will also suggest a MRI, a CT scan, a spinal tap and an eye test that will include a visual field test.
The doctor will rule out many other conditions first since there are other conditions that can cause this same pressure. Hydrocephalus, or water on the brain, can also cause these symptoms as can venous sinus thrombosis. For some patients who have this condition, their symptoms will slowly disappear with six months with about fifteen percent having recurring symptoms. For others, their symptoms will slowly get worse and eventually they will be blind. The name, pseudotumor cerebri actually translates to “false brain tumor” and very closely mimics many symptoms of a brain tumor. There are drugs that can be used to reduce fluid buildup and to relieve pressure in the skull. Weight loss and cessation of certain drugs can may lead to improvement and surgery may be performed as a way to remove pressure on the optic nerve to save the eye sight. This condition of high pressure in the fluid that surrounds the brain has a medical term called, idiopathic intracranial hypertension. Idiopathic means unknown cause, intracranial means inside the head and hypertension means fluid is under high pressure.
