Controversies in Diagnosis and Management of Pseudotumor Cerebri

To the Editor.  —As a group of neuroophthalmologists trained primarily in neurology, we believe that the CONTROVERSIES IN NEUROLOGY—presented in the February 1986 issue of the Archives—on diagnosis and management of pseudotumor cerebri failed to address the real controversies concerning this disorder.^1,2 We also disagree with the diagnostic methods proposed.In our opinion, the diagnostic criteria for pseudotumor cerebri do not require continuous monitoring of intracranial pressure. The patient should have signs and/or symptoms of increased intracranial pressure. Results of a neurologic examination should be normal except for signs of increased intracranial pressure. Results from neuroradiologic and other neurodiagnostic examinations should be normal except for elevated cerebrospinal fluid (CSF) pressure. Results of an evaluation for other causes of elevated intracranial pressure should be negative.Harold J. Hoffman, MD, FRCS(C),¹ suggests that the diagnosis be made by monitoring intracranial pressure by inserting a catheter into the