Diagnosing Pseudotumor Cerebri

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Adult Hydrocephalus Program

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An individual’s eye doctor may be the first person to suspect pseudotumor cerebri. The doctor may see swelling of the optic nerve, called papilledema, during a routine eye exam or a visit based on the patient’s concerns about recent vision changes.

Swelling of the optic nerve is one symptom of pseudotumor cerebri. This swelling can cause vision loss, so it is important to determine what is causing it. If your eye doctor suspects pseudotumor cerebri, he or she may refer you to a neurologist for more testing.

The main symptoms of pseudotumor cerebri include headaches, pulsatile tinnitus (hearing a whooshing noise in your head), dizziness or nausea, without any vision changes. If you have these symptoms, your primary care provider may be the first one to refer you to a neurologist for testing.

Evaluations and Testing

The Adult Hydrocephalus Team at the Swedish Neuroscience Institute includes many specialists who have experience diagnosing and treating pseudotumor cerebri.

Tests may include:

  • A thorough eye exam, which not only tests how well you see up close and in the distance, but also:
    • Visual field testing to determine if there are blind spots in your central or peripheral (side) vision
    • Color vision testing
    • Tests to evaluation how well your pupils function
    • Eye movement testing
    • An assessment of inside the eye to determine whether there is swelling of the optic nerve (papilledema)
  • MRIs and MR venography to be certain there is nothing within the skull creating increased pressure, to see how the cerebrospinal fluid (CSF) travels through the brain, and to rule out venous sinus thrombosis (blood clot in a channel in the brain through which blood travels)
  • Lumbar puncture (spinal tap in the lower back) to test a sample of CSF and measure the opening pressure