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February 28, 1977

Computerized Tomography and Benign Intracranial Hypertension-Reply

JAMA. 1977;237(9):871. doi:10.1001/jama.1977.03270360033007

It was Dr Weisberg's allusion to the possible use of CT scanning in evaluation of benign intracranial hypertension (BIH)1 that first prompted our study of the effectiveness of CT in confirming BIH. In answer to his first question, we have seen only one patient with papilledema without localizing neurological signs in whom the diagnosis of BIH was initially considered most likely (skull roentgenograms, EEG, brain scan, and CSF values were normal) but in whom the CT scan showed a midline third ventricular mass with hydrocephalus which proved to be a colloid cyst. We have seen three more patients with normal CT scans who have fulfilled the criteria for BIH. The presence or absence of focal neurological signs seems to be a primary factor that separates tumor cerebri from pseudotumor cerebri. Concerning the second question, all of our patients had CT scanning with and without contrast enhancement, and