Pseudotumor cerebri is most commonly seen in:
Correct Answer: Obese females in the age group 20-45 years
Description: Ans. a. Obese females in the age group 20-45 years (Ref: Harrison 19/e p203, l8/e p233)Pseudotumor cerebri is most commonly seen in obese females in the age group 20-45 years.Pseudotumor Cerebri (idiopathic Intracranial Hypertension)Benign self-limiting disorder with a favorable outcomeMajority of patients are young, female and obeseQIt occurs due to decreased CSF absorptionQMostly idiopathic in nature but seen in hypervitaminosis, expired tetracyclines, OCPs and steroid useQ.Causes of Pseudotumor Cerebri* High doses of vitamin AQ* Outdated TetracyclineQ* QuinolonesQ* HypoparathyroidismQ* Withdrawal of corticosteroid therapyQ* Addison's diseaseQ* SLEQClinical Features:Manifested by headache, papilledema, normal CSF and normal ventricle size on imaging.No focal neurological signsCharacteristic features of Pseudotumor CerebriElevated intracranial pressure (intracranial hypertension) with:Normal or Small sized ventricular systemQNo focal neurological signsQPapilledemaQ (enlarged blind spot in visual fluid)Normal CSF findingsQNormal CT scan, MRI and isotope brain scanQExcessive slow-wave activity on ECGQTreatment:Carbonic anhydrase inhibitor (acetazolamide) lowers ICP by reducing the production of CSF.Weight reduction is vital but often unsuccessful.If acetazolamide and weight loss fail and visual field loss is progressive, a shunt should be performed without delay to prevent blindness.Occasionally, emergency surgery is required for sudden blindness caused by fulminant papilledema.
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