Pseudotumor cerebri. A theory on etiology and pathogenesis

Area of Science:

• Neurology
• Endocrinology
• Radiology

Background:

• Pseudotumor cerebri (idiopathic intracranial hypertension) is characterized by increased intracranial pressure without a clear cause.
• Diagnostic criteria include bilateral papilledema and exclusion of intracranial masses or hydrocephalus.

Purpose of the Study:

• To investigate potential underlying pathologies in patients diagnosed with pseudotumor cerebri.
• To explore the relationship between sellar/pituitary abnormalities and the manifestation of pseudotumor cerebri.

Main Methods:

• Retrospective study of ten patients diagnosed with pseudotumor cerebri.
• Classification of patients into three groups based on radiological findings: empty sella, pituitary adenoma, or no sellar/pituitary pathology.
• Clinical assessment for symptom onset and neurological signs related to specific anatomical structures.

Main Results:

• Five patients presented with an empty sella, four of whom had an enlarged sella.
• Two patients had a pituitary adenoma, and three had no sellar or pituitary pathology.
• Acute symptom onset occurred in four patients; neurological deficits suggested involvement of the optic chiasm and cavernous sinuses in several cases.

Conclusions:

• Pseudotumor cerebri may be associated with underlying sellar and pituitary abnormalities.
• Bilateral cavernous sinus compression, potentially due to acute necrotic swelling of a pituitary adenoma, is proposed as a causative mechanism for pseudotumor cerebri.