Galgano Michael A, Deshaies Eric M
Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, NY, USA.
Clin Neurol Neurosurg. 2013 Mar;115(3):252-9. doi: 10.1016/j.clineuro.2012.11.018. Epub 2012 Dec 21.
Pseudotumor cerebri, or benign intracranial hypertension, is characterized by intracranial hypertension of unknown etiology typically in obese women <45 years of age, and can be disabling secondary to headaches and visual disturbances. Medical management includes pharmaceuticals that reduce cerebrospinal fluid (CSF) production and lumbar punctures that reduce the CSF volume, both aimed at reducing intracranial pressure. When medical management fails, surgical CSF diverting procedures are indicated. Recently it has been demonstrated that dural sinus stenosis or thrombosis can be responsible for this disease and treated with endovascular venous stent placement. The intent of this educational manuscript is to review the clinical presentation of pseudotumor cerebri patients and discuss the medical, surgical, and endovascular treatment options for this disease. After reading this paper, the reader should be able to: (1) understand the pathophysiological basis of pseudotumor cerebri, (2) describe its presenting signs and symptoms, and (3) discuss the medical, surgical, and endovascular treatment options.
假性脑瘤,即良性颅内高压,其特征为病因不明的颅内高压,多见于45岁以下的肥胖女性,可因头痛和视觉障碍而致残。药物治疗包括使用减少脑脊液(CSF)生成的药物以及进行减少CSF量的腰椎穿刺,两者均旨在降低颅内压。当药物治疗失败时,需进行手术脑脊液分流术。最近有研究表明,硬脑膜窦狭窄或血栓形成可能是该病的病因,可通过血管内静脉支架置入术进行治疗。本教育性文稿旨在回顾假性脑瘤患者的临床表现,并讨论该病的药物、手术和血管内治疗方案。阅读本文后,读者应能够:(1)理解假性脑瘤的病理生理基础;(2)描述其表现出的体征和症状;(3)讨论药物、手术和血管内治疗方案。