Pseudotumor cerebri differential diagnosis: Difference between revisions
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=== Secondary intracranial hypertension === | === Secondary intracranial hypertension === | ||
* Intracranial mass lesions (tumor, abscess) | * Intracranial mass lesions ([[tumor]], [[abscess]]) | ||
* Obstruction of venous outflow, eg, venous sinus thrombosis, jugular vein compression, neck surgery | * Obstruction of venous outflow, eg, [[Cerebral venous sinus thrombosis|venous sinus thrombosis]], jugular vein compression, neck surgery | ||
* Obstructive hydrocephalus | * [[Obstructive hydrocephalus]] | ||
* Decreased CSF absorption, eg, arachnoid granulation adhesions after bacterial or other infectious | * Decreased [[CSF]] absorption, eg, [[arachnoid granulation]] adhesions after [[bacterial]] or other infectious | ||
* meningitis, subarachnoid hemorrhage | * [[meningitis]], [[subarachnoid hemorrhage]] | ||
* Increased cerebrospinal fluid (CSF) production, eg, choroid plexus papilloma | * Increased cerebrospinal fluid ([[CSF]]) production, eg, [[choroid plexus papilloma]] | ||
* Malignant systemic hypertension | * [[Malignant hypertension|Malignant systemic hypertension]] | ||
Most of these condition can be ruled out by imaging techniques like MRI, CT scan and MR venography.<ref name="pmid10534264">{{cite journal |vauthors=Biousse V, Ameri A, Bousser MG |title=Isolated intracranial hypertension as the only sign of cerebral venous thrombosis |journal=Neurology |volume=53 |issue=7 |pages=1537–42 |date=October 1999 |pmid=10534264 |doi= |url=}}</ref><ref name="pmid14568121">{{cite journal |vauthors=Sylaja PN, Ahsan Moosa NV, Radhakrishnan K, Sankara Sarma P, Pradeep Kumar S |title=Differential diagnosis of patients with intracranial sinus venous thrombosis related isolated intracranial hypertension from those with idiopathic intracranial hypertension |journal=J. Neurol. Sci. |volume=215 |issue=1-2 |pages=9–12 |date=November 2003 |pmid=14568121 |doi= |url=}}</ref> | Most of these condition can be ruled out by imaging techniques like MRI, CT scan and MR venography.<ref name="pmid10534264">{{cite journal |vauthors=Biousse V, Ameri A, Bousser MG |title=Isolated intracranial hypertension as the only sign of cerebral venous thrombosis |journal=Neurology |volume=53 |issue=7 |pages=1537–42 |date=October 1999 |pmid=10534264 |doi= |url=}}</ref><ref name="pmid14568121">{{cite journal |vauthors=Sylaja PN, Ahsan Moosa NV, Radhakrishnan K, Sankara Sarma P, Pradeep Kumar S |title=Differential diagnosis of patients with intracranial sinus venous thrombosis related isolated intracranial hypertension from those with idiopathic intracranial hypertension |journal=J. Neurol. Sci. |volume=215 |issue=1-2 |pages=9–12 |date=November 2003 |pmid=14568121 |doi= |url=}}</ref> | ||
=== Bilateral disc abnormalities === | === Bilateral disc abnormalities === | ||
* Pseudopapilledema: Some non-diseased conditions like congenital disc abnormalities ( drusen and myelinated nerve fibers), farsightedness and hyperopia can cause the appearance of papilledema<ref name="pmid15513010">{{cite journal |vauthors=Davis PL, Jay WM |title=Optic nerve head drusen |journal=Semin Ophthalmol |volume=18 |issue=4 |pages=222–42 |date=December 2003 |pmid=15513010 |doi=10.1080/08820530390895244 |url=}}</ref><ref name="pmid12504737">{{cite journal |vauthors=Auw-Haedrich C, Staubach F, Witschel H |title=Optic disk drusen |journal=Surv Ophthalmol |volume=47 |issue=6 |pages=515–32 |date=2002 |pmid=12504737 |doi= |url=}}</ref> | * Pseudopapilledema: Some non-diseased conditions like congenital disc abnormalities ( [[drusen]] and myelinated nerve fibers), [[farsightedness]] and [[hyperopia]] can cause the appearance of [[papilledema]]<ref name="pmid15513010">{{cite journal |vauthors=Davis PL, Jay WM |title=Optic nerve head drusen |journal=Semin Ophthalmol |volume=18 |issue=4 |pages=222–42 |date=December 2003 |pmid=15513010 |doi=10.1080/08820530390895244 |url=}}</ref><ref name="pmid12504737">{{cite journal |vauthors=Auw-Haedrich C, Staubach F, Witschel H |title=Optic disk drusen |journal=Surv Ophthalmol |volume=47 |issue=6 |pages=515–32 |date=2002 |pmid=12504737 |doi= |url=}}</ref> | ||
* Malignant hypertention: Severe systemic hypertension can mimic papilledema but it also cause other signs like hemorrhages, exudates, cotton wool spots, diplopia, scotomata and photopsia which help us differentiate it from other causes of papilledema.<ref name="pmid11801269">{{cite journal |vauthors=Lee AG, Beaver HA |title=Acute bilateral optic disk edema with a macular star figure in a 12-year-old girl |journal=Surv Ophthalmol |volume=47 |issue=1 |pages=42–9 |date=2002 |pmid=11801269 |doi= |url=}}</ref><ref name="pmid10583722">{{cite journal |vauthors=Spencer CG, Lip GY, Beevers DG |title=Recurrent malignant hypertension: a report of two cases and review of the literature |journal=J. Intern. Med. |volume=246 |issue=5 |pages=513–6 |date=November 1999 |pmid=10583722 |doi= |url=}}</ref> | * [[Malignant hypertension|Malignant hypertention]]: Severe systemic hypertension can mimic [[papilledema]] but it also cause other signs like [[hemorrhages]], exudates, [[cotton wool spots]], [[diplopia]], scotomata and [[photopsia]] which help us differentiate it from other causes of [[papilledema]].<ref name="pmid11801269">{{cite journal |vauthors=Lee AG, Beaver HA |title=Acute bilateral optic disk edema with a macular star figure in a 12-year-old girl |journal=Surv Ophthalmol |volume=47 |issue=1 |pages=42–9 |date=2002 |pmid=11801269 |doi= |url=}}</ref><ref name="pmid10583722">{{cite journal |vauthors=Spencer CG, Lip GY, Beevers DG |title=Recurrent malignant hypertension: a report of two cases and review of the literature |journal=J. Intern. Med. |volume=246 |issue=5 |pages=513–6 |date=November 1999 |pmid=10583722 |doi= |url=}}</ref> | ||
* Diabetic papillopathy: Diabetic papillopathy can mimic papilledema from increased | * Diabetic papillopathy: Diabetic papillopathy can mimic [[papilledema]] from increased [[intracranial pressure]] with [[Telangiectasia|telangiectasias]], [[hemorrhages]] and macular star.<ref name="pmid11918898">{{cite journal |vauthors=Vaphiades MS |title=The disk edema dilemma |journal=Surv Ophthalmol |volume=47 |issue=2 |pages=183–8 |date=2002 |pmid=11918898 |doi= |url=}}</ref> | ||
* Hyperviscosity, hypotension, and blood loss<ref name="pmid12654358">{{cite journal |vauthors=Biousse V, Rucker JC, Vignal C, Crassard I, Katz BJ, Newman NJ |title=Anemia and papilledema |journal=Am. J. Ophthalmol. |volume=135 |issue=4 |pages=437–46 |date=April 2003 |pmid=12654358 |doi= |url=}}</ref> | * [[Hyperviscosity]], [[hypotension]], and [[blood loss]]<ref name="pmid12654358">{{cite journal |vauthors=Biousse V, Rucker JC, Vignal C, Crassard I, Katz BJ, Newman NJ |title=Anemia and papilledema |journal=Am. J. Ophthalmol. |volume=135 |issue=4 |pages=437–46 |date=April 2003 |pmid=12654358 |doi= |url=}}</ref> | ||
* Toxic optic neuropathies: methanol, ethambutol and ethylene glycol can cause papilledema early in their course.<ref name="pmid15590539">{{cite journal |vauthors=Delany C, Jay WM |title=Papilledema and abducens nerve palsy following ethylene glycol ingestion |journal=Semin Ophthalmol |volume=19 |issue=3-4 |pages=72–4 |date=2004 |pmid=15590539 |doi=10.1080/08820530490882733 |url=}}</ref> | * [[Toxic optic neuropathy|Toxic optic neuropathies]]: [[methanol]], [[ethambutol]] and [[ethylene glycol]] can cause [[papilledema]] early in their course.<ref name="pmid15590539">{{cite journal |vauthors=Delany C, Jay WM |title=Papilledema and abducens nerve palsy following ethylene glycol ingestion |journal=Semin Ophthalmol |volume=19 |issue=3-4 |pages=72–4 |date=2004 |pmid=15590539 |doi=10.1080/08820530490882733 |url=}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Differentiating [Disease name] from other Diseases
Pseudotumor cerebri must be differentiated from other diseases that cause increased intracranial pressure:
Secondary intracranial hypertension
- Obstruction of venous outflow, eg, venous sinus thrombosis, jugular vein compression, neck surgery
- Decreased CSF absorption, eg, arachnoid granulation adhesions after bacterial or other infectious
- meningitis, subarachnoid hemorrhage
- Increased cerebrospinal fluid (CSF) production, eg, choroid plexus papilloma
- Malignant systemic hypertension
Most of these condition can be ruled out by imaging techniques like MRI, CT scan and MR venography.[1][2]
Bilateral disc abnormalities
- Pseudopapilledema: Some non-diseased conditions like congenital disc abnormalities ( drusen and myelinated nerve fibers), farsightedness and hyperopia can cause the appearance of papilledema[3][4]
- Malignant hypertention: Severe systemic hypertension can mimic papilledema but it also cause other signs like hemorrhages, exudates, cotton wool spots, diplopia, scotomata and photopsia which help us differentiate it from other causes of papilledema.[5][6]
- Diabetic papillopathy: Diabetic papillopathy can mimic papilledema from increased intracranial pressure with telangiectasias, hemorrhages and macular star.[7]
- Hyperviscosity, hypotension, and blood loss[8]
- Toxic optic neuropathies: methanol, ethambutol and ethylene glycol can cause papilledema early in their course.[9]
References
- ↑ Biousse V, Ameri A, Bousser MG (October 1999). "Isolated intracranial hypertension as the only sign of cerebral venous thrombosis". Neurology. 53 (7): 1537–42. PMID 10534264.
- ↑ Sylaja PN, Ahsan Moosa NV, Radhakrishnan K, Sankara Sarma P, Pradeep Kumar S (November 2003). "Differential diagnosis of patients with intracranial sinus venous thrombosis related isolated intracranial hypertension from those with idiopathic intracranial hypertension". J. Neurol. Sci. 215 (1–2): 9–12. PMID 14568121.
- ↑ Davis PL, Jay WM (December 2003). "Optic nerve head drusen". Semin Ophthalmol. 18 (4): 222–42. doi:10.1080/08820530390895244. PMID 15513010.
- ↑ Auw-Haedrich C, Staubach F, Witschel H (2002). "Optic disk drusen". Surv Ophthalmol. 47 (6): 515–32. PMID 12504737.
- ↑ Lee AG, Beaver HA (2002). "Acute bilateral optic disk edema with a macular star figure in a 12-year-old girl". Surv Ophthalmol. 47 (1): 42–9. PMID 11801269.
- ↑ Spencer CG, Lip GY, Beevers DG (November 1999). "Recurrent malignant hypertension: a report of two cases and review of the literature". J. Intern. Med. 246 (5): 513–6. PMID 10583722.
- ↑ Vaphiades MS (2002). "The disk edema dilemma". Surv Ophthalmol. 47 (2): 183–8. PMID 11918898.
- ↑ Biousse V, Rucker JC, Vignal C, Crassard I, Katz BJ, Newman NJ (April 2003). "Anemia and papilledema". Am. J. Ophthalmol. 135 (4): 437–46. PMID 12654358.
- ↑ Delany C, Jay WM (2004). "Papilledema and abducens nerve palsy following ethylene glycol ingestion". Semin Ophthalmol. 19 (3–4): 72–4. doi:10.1080/08820530490882733. PMID 15590539.