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Pseudotumor Cerebri

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Some instances of pseudotumor cerebri may be caused by a narrowing (red circles) in the veins that drain blood from the brain (blue).

Pseudotumor cerebri is a common name for idiopathic intracranial hypertension (IIH), a condition that consists of high pressure in the fluid around the brain. The name pseudotumor cerebri comes from its symptoms (including headache, blurred or double vision, ringing in the ears), which are similar to those of a brain tumor. But pseudotumor cerebri/IIH is not a brain tumor — the presence of a tumor or other condition must be ruled out in order to make the diagnosis.

Pseudotumor cerebri occurs most commonly in women of childbearing age, particularly those who are overweight. Other risk factors include use of oral contraceptives or the antibiotic tetracycline (commonly prescribed for acne), or the use of human growth hormone.

Today we know that certain patients with pseudotumor cerebri/IIH have intracranial venous stenosis (a narrowing of the veins inside the brain). A new clinical trial shows great promise that inserting a stent to widen the veins will relieve the pressure and alleviate symptoms. (Find out more about the clinical trial.)

What Causes Pseudotumor Cerebri?
The body continually creates and absorbs cerebrospinal fluid (CSF), the fluid that circulates throughout the brain and spinal cord. When CSF is produced faster than it is absorbed, it creates pressure within the skull – there is simply no elasticity there to relieve pressure. Pseudotumor cerebri may be caused by the body creating too much CSF, absorbing too little, or both. Even though the cause of increased intracranial pressure is often elusive, high quality evidence from the last 10 years has identified venous sinus stenosis as a potential cause or related factor with pseudotumor cerebri. Venous sinus stenosis impairs the absorption of CSF, resulting in increased intracranial pressure.

On the following pages, you’ll discover more about the symptoms of pseudotumor cerebri, how pseudotumor cerebri is diagnosed and treated, and a highly promising new clinical trial to relieve it.

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Reviewed by: Srikanth Boddu, MD, MSc
Last reviewed/updated: August 2020
Illustrations by Thom Graves, CMI


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