Fwd: Diagnostic criteria for pseudotumore cerebri

 

 

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From: Djacobs272@aol.com
To: dhj1.neurology@blogger.com
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