Wednesday, May 14, 2014

Fwd: Diagnostic criteria for pseudotumore cerebri


Sent: 5/13/2014 2:29:29 P.M. Eastern Daylight Time
Subj: Diagnostic criteria for pseudotumore cerebri
Neurology 2013; 81:1161
A.  Required
       1.  Papilledema
       2.  normal neuro exam except cranial neuropathy eg abducens palsy
       3.  Neuroimaging-- normal MRI with and without contrast
       4.  Normal CSF composition
       5.  Elevated CSF opening pressure:  , > 250 in adults > 280 in clhildren
Diagnosis of pseudotumor cerebri syndrome without papilledema
       1.  If 2-5 above are satisfied and in addition unilateral or bilateral  VI n palsy
        2.  Absent papilledema/ VI n palsy, diagnosis is suggested but not made with 3/4 imaging criteria met:  empty sella, flattened posterior globe, distended perioptic subarachnoid space with or without tortuous optic nerve, and transverse sinus stenosis.
Under research:  findings of narrowed Meckel's cave and cavernous sinuses on MRI and widened foramen ovale on CT
Uncommon manifestations:  facial paresis, hemifacial spasm, radicular pain, rhinorrhea, otorrhea, III n , IV n and general oculoparesis.
Less specific symptoms of:  headache, transient visual obscurations, pulse synchronous tinnitus, binocular diplopia, neck shoulder and back pain

No comments: