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February 28, 1977

Computerized Tomography and Benign Intracranial Hypertension

JAMA. 1977;237(9):871. doi:10.1001/jama.1977.03270360033006

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To the Editor.—  Drs Delaney and Schellinger have reported the value of computerized tomography (CT) in evaluating patients with benign intracranial hypertension (BIH) (236: 951, 1976), but these authors do not comment on two aspects of this curious disorder.First, were there any patients who had increased intracranial pressure without localizing neurological signs in whom the diagnosis of BIH (pseudotumor cerebri) was initially considered most likely but in whom the CT scan showed evidence of a mass lesion or hydrocephalus? Second, what percentage of patients had scanning with and without contrast enhancement, and were there any cases in which the scan without contrast was negative but the scan after contrast enhancement showed a mass lesion?We (Weisberg, Nice, and Heath) have recently studied 62 patients with papilledema and no localizing signs by the CT scan (Radiology 122:133-136, 1977). Twenty-three patients were found to have lesions demonstrated by evidence of ventricular