Multidomain Cognitive Impairment in Children With Pseudotumor Cerebri Syndrome

Introduction:Patients with Pseudotumor Cerebri Syndrome (PTCS) may complain of difficulty in thinking or concentrating; however there has been little formal cognitive evaluation in this population.Objective:To evaluate the characteristics and nature of cognitive impairment in patients with PTCS.Methods:We retrospectively reviewed records of 10 patients diagnosed with PTCS who were cognitively tested at presentation. In each cognitive test, “Borderline deficit” (BD) was defined as a score more than 1 standard deviation (SD) below and “Definite Deficit” (DD) as a score more than 2 SD below the mean for age, sex and education. In each cognitive domain, impairment was defined as a single test score more than 2 SD below the mean, or scores of more than 1 SD below the mean for age, sex and education in > 50% of tests.Results:Mean age of patients was 43.4 ± 13.5 years. 8/10(80%) patients were female. 3/10(30%) had papilledema; 3/10(30%) had significant cerebral venous outflow obstruction. Impairment was most commonly seen and was most severe in the WMS logical memory I (BD44%, DD44%), WMS logical memory II (BD37.5%, DD50%), RAVLT delayed recall (BD30%, DD40%) and RAVLT retention(BD40%, DD30%) tests. Evaluation of cognitive domains revealed impairment in memory and learning (80%), executive function (10%), visuospatial skills (30%), and language (30%).Conclusion:Our results indicate that patients with PTCS can have significant cognitive impairment, particularly in learning and memory. The prevalence needs to be studied in a larger cohort. The relationship of cognitive impairment with chronically elevated intracranial pressures and its role in contributing to patient morbidity needs to be investigated further.

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Pseudotumor cerebri syndrome in a patient with narcolepsy type 1

European Journal of Paediatric Neurology ◽

10.1016/j.ejpn.2017.11.002 ◽

2018 ◽

Vol 22 (1) ◽

pp. 194-198 ◽

Cited By ~ 1

Author(s):

Thomas Rossor ◽

Ming Lim ◽

Kirandeep VanDenEshof ◽

Paul Gringras

Keyword(s):

Pseudotumor Cerebri ◽

Pseudotumor Cerebri Syndrome

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Pseudotumor cerebri syndrome: venous sinus obstruction and its treatment with stent placement

Journal of Neurosurgery ◽

10.3171/jns.2003.98.5.1045 ◽

2003 ◽

Vol 98 (5) ◽

pp. 1045-1055 ◽

Cited By ~ 146

Author(s):

Brian K. Owler ◽

Geoffrey Parker ◽

G. Michael Halmagyi ◽

Victoria G. Dunne ◽

Verity Grinnell ◽

...

Keyword(s):

Stent Placement ◽

Pseudotumor Cerebri ◽

Venous Sinus ◽

Stent Insertion ◽

Benign Intracranial Hypertension ◽

Content Type ◽

Venous Sinuses ◽

Pseudotumor Cerebri Syndrome ◽

New Treatment ◽

Fine Print

Object. Pseudotumor cerebri, or benign intracranial hypertension, is a condition of raised intracranial pressure in the absence of a mass lesion or cerebral edema. It is characterized by headache and visual deterioration that may culminate in blindness. Pseudotumor cerebri is caused by venous sinus obstruction in an unknown percentage of cases. The purpose of this study was to investigate the role of cerebral venous sinus disease in pseudotumor cerebri and the potential of endoluminal venous sinus stent placement as a new treatment. Methods. Nine consecutive patients in whom diagnoses of pseudotumor cerebri had been made underwent examination with direct retrograde cerebral venography (DRCV) and manometry to characterize the morphological features and venous pressures in their cerebral venous sinuses. The cerebrospinal fluid (CSF) pressure was measured simultaneously in two patients. If patients had an amenable lesion they were treated using an endoluminal venous sinus stent. Five patients demonstrated morphological obstruction of the venous transverse sinuses (TSs). All lesions were associated with a distinct pressure gradient and raised proximal venous sinus pressures. Four patients underwent stent insertion in the venous sinuses and reported that their headaches improved immediately after the procedure and remained so at 6 months. Vision was improved in three patients, whereas it remained poor in one despite normalized CSF pressures. Conclusions. Patients with pseudotumor cerebri should be evaluated with DRCV and manometry because venous TS obstruction is probably more common than is currently appreciated. In patients with a lesion of the venous sinuses, treatment with an endoluminal venous sinus stent is a viable alternative for amenable lesions.

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