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Pseudotumor Cerebri: Categorical Disease or Spectrum of Disease
Abstract
Methods: The charts of pseudotumor cerebri patients that underwent treatment during the past five years at our institution in Central Georgia were retrospectively reviewed. We collected data on age, ethnicity, obesity, presence of papilledema, comorbidities, radiographic findings, laboratory findings and treatment. The modified Dandy criteria for the diagnosis of pseudotumor cerebri were applied on the patients.
Results: The modified Dandy criteria applied to 23 patients with diagnosis of pseudotumor cerebri. The mean age was 35 and the range 15 to 62 years old. The average BMI was 39 and the range 22 to 62 kg/m2. All of the 23 patients were females. Fourteen patients (63.6%) had papilledema related to the diagnosis of idiopathic intracranial hypertension. Twelve (85.7%) patients of those with papilledema (14) were obese compared with five (55.6%) patients of those without papilledema (9). We had only two patients who had the full complex of symptoms including headaches, elevated opening pressure, papilledema and small cerebral ventricles. Six of seven diabetic patients had papilledema. Four of seven patients with arterial hypertension had papilledema. Two of three patients with chronic renal disease had papilledema. Four patients had low-lying cerebellar tonsils including three with papilledema.
Conclusions: A cohort of patients with pseudotumor cerebri diagnosis presents a spectrum of the disease with increasing severity. A significant percentage of these patients have metabolic comorbidities or intracranial malformations that may explain the symptoms and should be thoroughly investigated.
J Neurol Res. 2011;1(1):6-10
doi: https://doi.org/10.4021/jnr103e