Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)
Patient MRN: 111716
Female
49 years old
African American
Chief Complaint: Flashes and Floaters
Previous Diagnoses
Pseudotumor Cerebri
Papilledema
Sleep Apnea
Hypertension (150/95)
Presbyopia
Asthma
Medications and Supplements
Albuterol
Bisoprolol Fumarate (10mg)
Valsartan (160mg Tablet)
Ferrous Fumarate (324 mg Tablet)
Vitamin D
Iron
Laser Eye Surgery for "Hole in Eye" ~20 years ago
Family History
Father
Diabetes
Mother
Hypertension
Visual Acuity
Far Aided with Spectacles
OD: 20/60-1
OS: 20/70-1
OU: 20/40+2
Far Aides with Spectacles and Pinhole
OD: 20/40+2
OS: 20/40
Near Aided with Spectacles
OD: 20/30
OS: 20/25
OU: 20/20
IOP
OD: 15 mmHg
OS: 16 mmHg
Findings
Vitreous Opacities
Possible Posterior Vitreous Detachment (PVD)
Lumbar Puncture
Increased Intracranial Pressure (ICP)
Differential Diagnosis: Must be a form of Pseudotumor Cerebri
Not glaucoma
IOP's are within normal range
(Clara & Ribiero, 2015)
No clear indication of cause-->idiopathic
Correlational studies such as from Clara and Ribiero (2015) suggest that the cause of pseudotumor cerebri is correlated with females, obesity, hypertension, and increased BMI
(Clara & Ribiero, 2015)
Possibility of some visual field loss
Patient was unable to obtain a distance VA better than 20/40 suggesting that there must be ocular disease present and possibly some visual field loss
(Clara & Ribiero, 2015)
Papilledema
Major indication of PTC
(Clara & Ribiero, 2015)
Increased ICP without neurological findings
Major indication of PTC
(Clara & Ribiero, 2015)
Pseudotumor Cerebri
Epidemiological Data: Correlational Study by Clara and Ribiero (2015)
50 Subjects (43 F, 7 M)
Study Parameters
Sex
Weight
Body Mass Index (BMI)
History of Hypertension
Visual Symptoms
Time from Original Diagnosis
Best Corrected VA
Results
Associated with females-->6:1 ratio (F:M)
Associated with obesity or being overweight-->increased BMI of 32 kg/cm^2 (class I obesity)
Associated with headaches-->80%
Associated with vision loss-->86%
More Information
Concerns with Disease
Causes an increased pressure on the optic nerve resulting in permanent damage
(Clara & Ribiero, 2015)
Possible visual field loss due to papilledema
(Clara & Ribiero, 2015)
Possible retinal hemorrhages
(Clara & Ribiero, 2015)
2 Types
Primary
Idiopathic, occurs without a known cause. Currently thought to be associated with obese/overweight females.
(Paley et al., 2015)
Secondary
Caused by medications or other preexisting conditions
(Paley et al., 2015)