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Medicine All India exam 42f83ddf

All of the following are recognized features of pseudotumor cerebri, except:

A
Papilledema
B
Absence of true localizing neurological deficit
C
Increased protein content in the CSF
D
Normal sized ventricles on CT scanning
High-Yield Explanation
Pseudotumor CerebriAlso called as idiopathic intracranial hypeension Pseudotumor cerebri (PTC), is a neurological disorder that is characterized by increased intracranial pressure (pressure around the brain) in the absence of a tumor or other diseases. Occur in young and obese woman Symptoms - headache, nausea, and vomiting, pulsatile tinnitus, double vision, swelling of the optic disc in the eye, which can progress to vision lossCauses of Pseudotumor cerebriDiagnostic criteria - Modified Dandy criteriaHigh-dose vitamin A derivatives (e.g. isotretinoin for acne), long-term tetracycline antibiotics (for a variety of skin conditions) and hormonal contraceptivesSecondary intracranial hypeension includes obstructive sleep apnea (a sleep-related breathing disorder), systemic lupus erythematosus (SLE), chronic kidney disease, and Behcet&;s diseaseSymptoms of raised intracranial pressure (headache, nausea, vomiting, transient visual obscurations, or papilledema)No localizing signs with the exception of abducens (sixth) nerve palsy)The patient is awake and aleNormal CT/MRI findings without evidence of thrombosisLP opening pressure of >25 cmH2O and normal biochemical and cytological composition of CSFNo other explanation for the raised intracranial pressureManagement Discontinue the offending drug & treat the etiology Weight reduction Lumbar puncture offers transient relief Surgical management Optic nerve sheath fenestrationLumboperitoneal shunt Venous sinus stenting (Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 123,233)

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