Pseudotumor Cerebri (or Idiopathic Intracranial Hypertension)

Pseudotumor cerebri (PTC) or idiopathic intracranial hypertension (IIH) is a condition in which the pressure from the cerebral spinal fluid inside your head is elevated. This can cause problems such as headaches, blurred vision, or loss of vision. The condition is known as pseudotumor cerebri because symptoms can mimic those of a tumor.

The cerebral spinal fluid (CSF) is a clear fluid that bathes the brain and spinal cord. In cases of PTC, the pressure in this fluid is elevated. The pressure causes swelling of the optic nerve (in the back of the eye) which can lead to loss of vision. It can also damage the nerves that control eye movement, resulting in double vision.

The causes of PTC are not certain, but they may include the following:

  • Obesity
  • Hormonal influences, in young women
  • Certain antibiotics
  • Steroids
  • High doses of vitamin A.

The most common symptoms of PTC are headache and visual loss. The headache can be located anywhere, but is usually in the back of the head. It may wake you in the middle of the night, and it may worsen with bending or stooping. Other symptoms include:

  • Dimming, blurring, or graying of vision;
  • Difficulty seeing to the side;
  • Brief visual disturbances;
  • Double vision;
  • Rushing noise in the ears; and
  • Nausea and vomiting.

Your ophthalmologist will give you a complete eye examination. It may be necessary for you to have an MRI scan and spinal tap to assure accurate diagnosis and to rule out other abnormalities of the cerebrospinal fluid.

If your symptoms are mild, no treatment other than weight loss and careful monitoring may be necessary. Often medications (diuretics) can help lower CSF pressure.

If your vision continues to deteriorate after you have begun treatment, surgical procedures may be undertaken in order to protect the optic nerves from any further damage.