Definition: It is the name given to the increase in intracerebral pressure without a lesion occupying space in the brain (brain tumor). It is more common in women, especially in obese people, and in middle age. While its normal incidence is 1/100,000, it is seen with a higher frequency of 19.3/100,000 in obese women.
What are the causes of pseudotumor cerebri (false brain tumor)? It is suggested that brain edema, increased cerebral blood flow, increased production or decreased absorption of cerebrospinal water (CSF), as well as obstruction of brain venous blood flow, play a role in the formation of the disease. Among the primary causes of this disease, female gender, obesity, hormonal and inflammatory causes, as well as secondary causes (venous sinus thrombosis in the brain, hypercoagulopathies, some medications used (antibiotics, steroids, hypervitaminosis A, blood diseases) are listed among the causes. All these known in this disease. Despite the reasons, there are also unknown causes at a rate of 20%.
What are the clinical complaints of pseudotumor cerebri (false brain tumor); Headache and vision complaints (double vision, blurred vision, rarely strabismus and Vision loss or visual field loss are the most well-known complaints and findings. Headache occurs after increased intracerebral pressure and is accompanied by complaints of nausea, sometimes vomiting, and tinnitus. Rarely, balance disorder (ataxia) may be seen among the symptoms.
How is pseudotumor cerebri (false brain tumor) diagnosed?? Neurological examination is generally normal except for optic nerve edema or atrophy in the eye examination. After edema of this nerve, blurred vision, double vision, and sometimes vision loss occur. Among brain imaging tests, Magnetic Resonance (MRI) and other brain diagnostic methods are normal, but systemic laboratory and blood tests should be investigated in detail to determine the causes. Cerebral fluid (CSF) pressure measurement and height taken from the waist, which clearly shows the brain pressure, are very important in the definitive diagnosis of the disease.
What are the treatments for pseudotumor cerebri (false brain tumor)?
Medicine It should be examined under two headings: treatment and surgical treatment. The success of the treatment must first be confirmed by the diagnosis and the predisposing risk factors, the primary and secondary causes listed above, must be investigated in detail. In medical treatment, if there is obesity or continuous medication use, it should first be corrected. Drugs and diuretic drugs that reduce increased brain pressure are used. The patient's complaints may or may not improve with lumbar puncture, which is a test performed from the waist to reduce brain pressure. However, patients whose vision complaints or symptoms progress despite medical treatment are candidates for surgical treatment. The main purpose here is to reduce the pressure on the optic nerve. For this purpose, different surgical interventions; Surgical treatment of increased intracranial pressure is performed by placing optic nerve fenestrations and catheters into the spinal cord at the waist or into the brain pool (ventricle).
As a result If there are predisposing risk factors for this disease, their elimination is very important in the treatment, and if the patients whose vision complaints progress or do not improve in the visual acuity and visual field examination, surgical treatment options should be applied before permanent blindness occurs. .
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