Pseudotumor cerebri is an impressive sounding syndrome that has much of pseudo and little of tumor. A number of conditions can manifest with increased intracranial pressure,1 but few produce or behave like a brain tumor. Moreover, most cases of pseudotumor cerebri have no identifiable cause. This controversy is about the diagnosis and management of a pathophysiologic entity that usually resolves but may lead to permanent visual or neurologic deficits.
Dr Hoffman emphasizes that the only reliable way to establish the fact and degree of intracranial pressure is by measuring it. Dr McGreal points out that the majority of patients do well and thinks that long-term intracranial pressure monitoring is seldom necessary.
Since clinical characterization has failed to distinguish the few patients in jeopardy from the many who are not, a new look at the problem with proton and sodium magnetic resonance may identify and monitor therapeutic subtypes. The syndrome
Hachinski V. Pseudotumor Cerebri. Arch Neurol. 1986;43(2):168. doi:10.1001/archneur.1986.00520020056022
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