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May be ex-library. Buy with confidence, excellent customer service!. Bookseller Inventory Ask Seller a Question. About this title Synopsis: Pseudotumor cerebri, also known as idiopathic intracranial hypertension or benign intracranial hypertension, is a condition that occurs when the intracranial pressure the pressure that exerted inside your skull or cranial vault increases due to the accumulation of cerebrospinal fluid in the cranium. Excellent customer service. Shipping Terms: Standard and expedited shipping options include shipping and handling costs. Add to Wants. A number of risk factors are associated with developing Pseudotumor Cerebri.
Recent weight gain is strongly linked with this condition. It occurs more commonly in women than in men. There are several medications associated with the development of Pseudotumor Cerebri. These include certain antibiotics in the tetracycline family and medicines derived from vitamin A including treatments for acne. Other medications may also be associated with Pseudotumor Cerebri, but are not as well established as definite risk factors. The doctor will diagnose Pseudotumor Cerebri based on symptoms and the results of the examination and diagnostic tests.
Patients with Pseudotumor Cerebri have swelling of the optic nerve that is visible to the physician during examination with the ophthalmoscope. Sometimes areas of poor circulation or bleeding in the retina are also visible. There may also be loss of peripheral vision, depending on the severity of the condition. Unless severe visual loss has already occurred, the ability to read the eye chart and color vision are typically normal. In order to diagnose a patient with Pseudotumor Cerebri, the doctor will have to order additional tests.
An MRI uses a large magnet to take a detailed picture of the brain it does not use X-ray radiation. The MRI will check if there is an abnormal growth in the brain or its coverings that is the reason for elevated pressure in the skull. It will also check for blood clots in the major veins in the brain. A small sample of the fluid is collected to check if there is any infection or inflammation that has caused elevated pressure. In patients with Pseudotumor Cerebri, the pressure is elevated but the cerebrospinal fluid itself is normal.
The goal in treating Pseudotumor Cerebri is to use appropriate measures to reduce pressure within the skull and prevent further visual loss. Often this requires a combination of treatments.
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If a patient with Pseudotumor Cerebri has had recent weight gain, one of the most important ways to treat this condition is weight loss. New emerging studies which are of promising future value are evaluating the effect of octreotide, a growth hormone and insulin-like growth factor inhibitor, for the reduction of ICP. Corbett and colleagues have provided potential indications for surgery in patients with IIH:. The two most used procedures are CSF diversion via shunt and optic nerve sheath fenestration.
Optic nerve sheath fenestration is the preferred surgical procedure for papilledema with associated severe vision loss but no or minimal ICP symptoms such as headache. The procedure involves incisions in the abnormally bulbous anterior dural covering of the optic nerve sheath which creates an outlet for continuous CSF drainage. Consequently, the CSF no longer distends the sheath and axoplasmic flow in the optic nerve is restored. It is also considered to be the safest approach among patients with renal failure requiring hemodialysis and for vision loss occurring during pregnancy.
Two types are available: lumbo-peritoneal LP and ventriculo-peritoneal VP.
Although VP shunting is more difficult, as IIH patients do not have enlarged ventricles, it is the preferred method due to its lower complication rate. Complications of CSF shunting including shunt obstruction, shunt migration, intracranial hypotension, and tonsillar herniation.
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Sinclair et al. After identification of the stenotic area on MRV, further testing e. Some studies have demonstrated improvement in symptoms following this procedure.
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However, despite its possible beneficial outcomes, the procedure may be associated with serious complications such as stent migration, venous sinus perforation, in-stent thrombosis, subdural hemorrhage and recurrent stenosis formation proximal to the stent. Treatment approach is similar in the pediatric population however surgical intervention should be considered earlier as visual field testing is often inaccurate in this patient population.
The course of the disease is variable and may vary from weeks to years. To date there are no prospective studies that have evaluated the natural history of the disease. Nonetheless, many patients may not fully recover and demonstrate persistent visual field defect, disc edema or elevated opening pressures on lumbar puncture. Permanent visual loss is the major morbidity and is mostly related to the severity of papilledema.
Pseudotumor cerebri (idiopathic intracranial hypertension) - EyeWiki
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