All of the following are recognized features of pseudotumor cerebri, except:: (A) Papilledema, (B) Absence of true localizing neurological deficit, (C) Increased protein content in the CSF, (D) Normal sized ventricles on CT scanning
Answer is C. Pseudotumor CerebriAlso called as idiopathic intracranial hypeension Pseudotumor cerebri (PTC), is a neurological disorder that is characterized by increased intracranial pressure (pressure around the brain) in the absence of a tumor or other diseases. Occur in young and obese woman Symptoms - headache, nausea, and vomiting, pulsatile tinnitus, double vision, swelling of the optic disc in the eye, which can progress to vision lossCauses of Pseudotumor cerebriDiagnostic criteria - Modified Dandy criteriaHigh-dose vitamin A derivatives (e.g. isotretinoin for acne), long-term tetracycline antibiotics (for a variety of skin conditions) and hormonal contraceptivesSecondary intracranial hypeension includes obstructive sleep apnea (a sleep-related breathing disorder), systemic lupus erythematosus (SLE), chronic kidney disease, and Behcet&;s diseaseSymptoms of raised intracranial pressure (headache, nausea, vomiting, transient visual obscurations, or papilledema)No localizing signs with the exception of abducens (sixth) nerve palsy)The patient is awake and aleNormal CT/MRI findings without evidence of thrombosisLP opening pressure of >25 cmH2O and normal biochemical and cytological composition of CSFNo other explanation for the raised intracranial pressureManagement Discontinue the offending drug & treat the etiology Weight reduction Lumbar puncture offers transient relief Surgical management Optic nerve sheath fenestrationLumboperitoneal shunt Venous sinus stenting (Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 123,233)