Pathogenesis of pseudotumor cerebri syndromes

Intracranial hypertension in the absence of an intracranial mass lesion or hydrocephalus can be caused by an alteration of one or more of the four determinants of cerebrospinal fluid (CSF) pressure: (1) intrasagittal sinus pressure, (2) resistance of arachnoid villi to the egress of CSF, (3) rate of production of CSF, and (4) compliance of the CSF space. The pseudotumor cerebri syndrome of obese young women may be caused partially by increased CSF production. Estrone (produced by the conversion of androstenedione by adipocytes) probably induces the menstrual irregularities of these women and may affect CSF secretion. Pseudotumor cerebri syndromes associated with other conditions may be separated into pathogenic categories.