Understanding the Pseudotumor Cerebri in Idiopathic Intracranial Hypertension: A Systematic Review
Daniel A. Encarnacion-Santos, Ismail Bozkurt, Emmanuel Batista Geraldino, Bipin Chaurasia, Gennady Chmutin, Egor G. ChmutinBackground and Aim:
Pseudotumor cerebri (PTC), also called benign intracranial hypertension, is characterised by increased intracranial pressure (ICP), optic nerve damage, vision problems, and papilledema. First identified by Heinrich Quincke in 1893, this condition can arise from various causes, such as venous stenosis, cerebrospinal fluid (CSF) abnormalities, hormonal imbalances, excess vitamin A, and certain medications like tetracycline.
Materials and Methods:
A systematic review was conducted following PRISMA guidelines, focusing on PTC and idiopathic intracranial hypertension (IIH). The review analysed diagnosis, surgical management, complications, and affected populations. Databases such as PubMed and ScienceDirect were searched using terms like ‘pseudotumor cerebri’, ‘IIH’ and ‘intracranial pressure’. Data from relevant studies were analysed using SPSS and Excel.
Results:
This review included data from 12,307 patients, presented in several tables and figures. Notably, a review of Cushing’s disease surgeries at the University of Virginia (1982–2008) found seven cases of PTC as a late complication in a cohort of 941 surgeries, affecting both children and adults.
Conclusion:
PTC and IIH require tailored management. Medications such as acetazolamide, topiramate, and diuretics like furosemide are recommended as first-line treatments. Weight loss, including bariatric surgery, is advised for overweight patients to help reduce ICP. Surgery is considered when medical treatments are ineffective.