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COPYRIGHT 2004 Reed Business Information, Inc. (US)
Signs and Symptoms
Pseudotumor cerebri (PTC), also known as idiopathic intracranial hypertension, is encountered most frequently in young, overweight women between the ages of 20 and 45. (1), (2) Headache is the most common presenting complaint, occurring in more than 90% of cases seen. (3) Dizziness, nausea and vomiting may also be encountered, but typically there are no alterations of consciousness or higher cognitive function. Tinnitus, or a "rushing" sound in the ears, is another frequent complaint. Visual symptoms are present in up to 70% of all patients with PTC, and include transient visual obscurations, general blurriness, and intermittent horizontal diplopia. (3) These symptoms tend to worsen in association with Valsalva maneuvers and changes in posture.
Funduscopic evaluation demonstrates bilaterally swollen, edematous optic nerves consistent with true papilledema. Ophthalmoscopy may reveal striations within the nerve fiber layer, blurring of the superior and inferior margins of the neural rim, disc hyperemia, and capillary dilation. More severe presentations involve engorged and tortuous retinal venules, peripapillary hemorrhages and/or cotton-wool spots, and circumferential retinal microfolds (Paton's lines). Chronic papilledema may result in atrophy of the nerve head, with associated pallor and gliosis. Most cases of true papilledema will not present with a...
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