Pseudotumor Cerebri Treatment Specialists in Hackensack, NJ
Pseudotumor cerebri (PTC) occurs when the cerebrospinal fluid - liquid that nourishes and protects the brain and spine - builds up in the skull. This fluid buildup causes intracranial hypertension, or pressure inside the skull. Also known as a fake brain tumor, PTC causes tumor-like symptoms such as headache and vision problems without presence of an actual brain tumor.
Diagnosis and treatment of pseudotumor cerebri are crucial because progressive PTC can cause blindness. If you are experiencing symptoms of PTC, you should seek medical attention.
To schedule a consultation with a neurologist in Hackensack who specializes in pseudotumor cerebri diagnosis and treatment, call (201) 806-6099 or contact Dr. M.T. Shahab online.
What Is Pseudotumor Cerebri?
Pseudotumor cerebri (PTC), also called idiopathic intracranial hypertension (IIH), occurs when the pressure inside the skull increases, causing stress on the brain and optic nerves. The spike in pressure is caused by excess buildup of cerebrospinal fluid (CSF), due to the body either producing too much CSF or not reabsorbing enough of it.
Causes of Pseudotumor Cerebri
Idiopathic intracranial hypertension causes have not yet been identified, which is why the condition is referred to as idiopathic, meaning "of unknown cause." Despite no pseudotumor cerebri causes having been determined, several risk factors have been identified.
Obesity - especially central obesity, or fat around the middle of the abdomen - is the leading risk factor for pseudotumor cerebri. Other risk factors for PTC include:
- Having taken the antibiotic tetracycline
- Having taken birth control pills
- Previous use of steroids
- Excessive vitamin A consumption
- Kidney disease
- Sleep apnea
- Addison's disease
- Lyme disease
- Birth defects that cause narrowing of blood vessels in the brain
Symptoms of Pseudotumor Cerebri
Pseudotumor cerebri symptoms mimic those of brain tumors. The most common symptom of PTC is a throbbing headache that worsens just after waking up; according to a study done by the journal Neurosurgery, 92-94% of PTC patients experience this symptom.
Other symptoms can include:
- Vision problems like flashes of light, brief episodes of blindness, double vision, or blurred vision
- Ringing in the ears
- Neck, back, or shoulder pain
Diagnosis of Pseudotumor Cerebri
Diagnosis of PTC is reliant on finding increased buildup of cerebrospinal fluid in the skull cavity without any obvious cause. The first step in pseudotumor cerebri diagnosis is discussion of your symptoms and medical history with your healthcare provider. Tests that may be performed include:
- Examination with an ophthalmoscope to check your optic nerve for signs of swelling
- Lumbar puncture (spinal tap) to check for increased pressure in the skull
- CT scan to take a detailed image of the brain
- MRI to look for increased pressure or abnormal growths in the brain
- Vision tests to check for blind spots
Treatment for Pseudotumor Cerebri
Pseudotumor cerebri treatment most commonly involves medication or surgery. In some cases, a neurologist may recommend multiple spinal taps as intracranial hypertension treatment because this will relieve the pressure in the skull. As obesity has been identified as a risk factor for PTC, It may also be recommended that obese patients lose weight.
Medications that can be used to treat PTC include:
- Migraine medications such as Imitrex and Amerge to alleviate headache pain
- Glaucoma drugs such as Diamox to decrease production of cerebrospinal fluid
- Diuretics like Lasix to decrease fluid retention in the body
Pseudotumor cerebri surgery may be necessary if your vision becomes worse or if medication is not sufficient to lessen the pressure on the brain. There are three surgeries available to treat PTC:
Optic nerve sheath fenestration (ONSF): severing the membrane around the optic nerve to let the extra cerebrospinal fluid out
ONSF has been found to be relatively safe and effective in treatment for vision loss due to PTC and, if performed early enough, may cure PTC-related vision loss. After ONSF, you may be admitted to the hospital for overnight observation. Recovery is relatively pain-free and takes 1 to 2 weeks, at which point your vision will need to be tested to make sure you are healing properly.
Spinal fluid shunt placement: placement of a thin tube in the brain or lower spine to drain lower fluid, usually into the abdominal cavity
Spinal fluid shunt placement is typically done in more severe cases, but it is less likely than ONSF to cause low pressure in the skull. A shunt may also be used if ONSF is unsuccessful. After a shunt placement, you will be under observation for 24 hours and may need to stay in the hospital for between 2 and 7 days. You may have intermittent headaches, but these should resolve over time. Recovery from a shunt usually takes 4 to 6 weeks.
Gastric bypass or laparoscopic adjustable gastric banding: reduction of stomach size as a method for dramatic weight loss, as obesity is known to contribute to PTC
Gastric surgery is almost exclusively performed on PTC patients who are morbidly obese. After gastric surgery, you will likely have to stay in the hospital for 2 to 3 days. Recovery normally takes 3 to 5 weeks, depending on the type of surgery you underwent. You will likely also have to work with a nutritionist to revise your diet, as you will be able to eat less.
You will need regular vision checkups after treatment to ensure that your vision does not continue to change.
Request Your Appointment Today
Pseudotumor cerebri is a serious, degenerative condition, but effective treatments are available.
If you are experiencing symptoms of PTC, find a neurologist in Hackensack by calling (201) 806-6099 or contact Dr. M.T. Shahab online.
Medwell Orthopedics & Functional Medicine for Men & Women
Address33 Central Ave
Midland Park, NJ 07432
8:00 am - 8:00 pm
Tue: 2:00 pm - 7:00 pm
Wed: 8:00 am - 6:30 pm
Thu: 8:00 am - 1:00 pm
Fri: 8:00 am - 6:30 pm
Sat: 9:00 am - 1:00 pm
Sun: By Appointment Only