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Pseudotumour cerebri syndrome due to cryptococcal meningitis
P D Cremer1, I H Johnston, G M Halmagyi
1Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia.
Journal of Neurology, Neurosurgery, and Psychiatry
|January 1, 1997
Summary
Cryptococcal meningitis can cause pseudotumor cerebri syndrome, characterized by intracranial hypertension. Treatments like optic nerve sheath decompression and CSF shunting effectively managed symptoms in three patients.
Area of Science:
- Neurology
- Infectious Diseases
- Ophthalmology
Background:
- Pseudotumor cerebri syndrome (PTCS) presents as intracranial hypertension without identifiable mass lesions or ventricular enlargement.
- Cryptococcal meningitis, an opportunistic infection, can lead to increased intracranial pressure.
- Understanding the diverse etiologies of PTCS is crucial for effective management.
Observation:
- Three cases of PTCS secondary to cryptococcal meningitis are presented.
- Patients exhibited papilledema and elevated intracranial pressure attributed to the fungal infection.
- The absence of mass lesions or hydrocephalus was confirmed in these cases.
Findings:
- Optic nerve sheath decompression successfully treated papilledema in affected patients.
- Lumboperitoneal cerebrospinal fluid (CSF) shunting effectively reduced intracranial hypertension.
- These interventions highlight the potential for managing PTCS symptoms even in complex infectious cases.
Implications:
- These findings support the concept of PTCS as a syndrome resulting from CSF pathway obstruction, particularly at the arachnoid villi level.
- Recognizing infectious causes like cryptococcal meningitis is vital for diagnosing and treating PTCS.
- Therapeutic strategies aimed at normalizing intracranial pressure are essential for preserving vision in PTCS patients.