Título / Title

PSEUDOTUMOR CEREBRI: A CASE REPORT

Introdução / Purpose

Pseudotumor cerebri is a condition observed in obese women of childbearing age. The incidence in normal-weight people is of 1 case in 100.000, while in obese people the incidence turns to 20 cases in 100.000. The most importante complication is visual loss, which occurs in 20% of cases and is related to persistently increased cerebrospinal pressure.

Material e Método / Methods

This is the case report of a woman, 25 years old, obese (CMI index of 32kg/m2), who presented with bilateral blurred vision, nausea, and severe headache.
On examination, biomicroscopy and intraocular pressure were normal in both eyes. However, best corrected visual accuity was of 20/40 in both eyes and evaluation of posterior pole revealed important bilateral papilledema.

Resultados / Results

The hypothesis of pseudotumor cerebri was raised and the patient was referred to a neurologist, besides starting treatment with diamox.
The patient returned two months later, still using diamox, with a normal cranial magnetic ressonance image and a normal aspect of the nerve optic head. Best corrected visual accuity improved to 20/20.

Discussão e Conclusões / Conclusion

Pseudotumor cerebri syndrome has signs and symptoms characteristic from intracranial hypertension: headache, náusea, vomiting, transiente vision obscuration, tinnitus, papilledema, diplopia and visual loss. Diagnosis is done using clinical features, analysis of cerebrospinal fluid pressure and neurodiagnostic image studies to rule out other causes of increased intracranial hypertension. Weight loss improves the condition. When this measure by itself is no enough, treatment can include: diuretics, digoxin, repeated lombar punctures, subtemporal descompression, optic nerve sheath descompression, and creation of lumboperitoneal or ventriculoperitoneal shunts.

Palavras Chave

Pseudotumor cerebri; papilledema; intracranial hypertension;

Area

CLINICAL RETINA