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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Benign intracranial hypertension is known to be associated with obesity, endocrine abnormalities, various medications, and cerebral venous sinus thrombosis. We report a patient presenting with headaches and vomiting attributed to benign intracranial hypertension. The diagnostic work-up revealed Langerhans' cell histiocytosis of the occipital bone. There was no evidence for cerebral vein thrombosis by cranial computed tomography scan, Doppler ultrasonography, planar and single photon emission computed tomography technetium 99m-labelled red blood cell scintigraphy, and magnetic resonance angiography. Excision of the occipital bone lesion and a short course of acetazolamide and prednisone were curative. We hypothesize that cytokines secreted by the tumor were responsible for the development of intracranial hypertension.
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PMID:Langerhans' cell histiocytosis presenting as intracranial hypertension. 1141 6

Pseudotumor cerebri is a condition of intracranial hypertension without localizing signs except for papilledema with normal intracranial contents and normal cerebrospinal fluid constituents. It is seen more frequently in women than in men (8:1) especially women are of childbearing age, and in 90% of cases of obesity. The most common symptoms are headache and visual obscuration. Other symptoms include pulsatile tinnitus, shoulder and arm pain. The papilledema present in almost all PTC patients can lead to decreased vision and blindness. One third of the large series had substantial visual loss including loss of visual field. Treatment has been directed toward preserving vision. Medications that reduce intracranial pressure such as diuretics like Acetazolamide have some success. When vision is threatened, these individuals may undergo optic nerve sheath decompression or lumbar peritoneal shunt to preserve vision. Even with prompt intervention, visual loss can occur.
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PMID:[Pseudotumor cerebri (PTC--an update)]. 1194 27

Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, can be a serious vision-threatening disease. Visual acuity, visual fields, and ocular fundus appearance should be followed closely in all patients with IIH. Obese patients with IIH should be encouraged to lose weight. Medications that might cause or exacerbate IIH should be identified and discontinued if possible. Mild headaches can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) or migraine prophylactic agents. Some patients may not require additional treatment if they are otherwise asymptomatic and have no evidence of vision loss. Symptomatic patients (significant headache, visual complaints, tinnitus) or patients with visual field or acuity loss should be treated initially with acetazolamide. Furosemide may be a useful second-line agent. If vision loss is progressive despite maximal medical therapy or severe at the time of diagnosis, surgical intervention may be required. Optic nerve sheath fenestration is effective and safe, and may be repeated if initially unsuccessful. Lumboperitoneal shunting is also an option, especially if symptoms of headache are prominent and refractory to medical therapy, but it has significant complication and failure rates. Bariatric surgery can be an effective treatment for IIH in severely obese patients, but is not a useful acute intervention. Special issues must be considered when treating IIH in children or pregnant women.
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PMID:Idiopathic Intracranial Hypertension. 1203 3

We report two cases of bilateral papilledema in young women. The first patient was 15 years old and had experienced headaches and vomiting for one month, but no visual loss. Cerebral tomodensitometry results were normal, but lumbar puncture showed increased pressure and normal biology. Benign intracranial hypertension was diagnosed. Recent treatment with minocycline for acne vulgaris was the only etiology. Papilledema was totally regressed at 6 weeks, after interruption of the antibiotic treatment. A prescription of acetazolamide was added for a short period of 10 days. The second patient, aged 29 years, presented bilateral papilledema with severe visual loss, with vision limited to light perception with mydriasis of the right eye. Lumbar puncture was not indicated because of a hypophyseal microadenoma revealed on MRI investigation. No other associated abnormalities were observed, in particular, no cerebral sinus thrombosis. Corticotherapy using prednisolone for 72 hours had no clinical effect. Fast visual recovery was obtained with intravenous acetazolamide therapy and was completely resolved at 2 months. Right visual field defects persisted. Minocycline and obesity are recognized as precipitating factors in pseudotumor cerebri syndrome. The literature advocates consideration of surgical treatment by optic nerve sheath fenestration if antiedematous treatment has no effect and the eye is nearly blind.
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PMID:[Bilateral papilledema in young women: two case reports of benign intracranial hypertension?]. 1247 53

The aim of this study was to determine the features of pseudotumor cerebri or idiopathic intracranial hypertension in prepubertal and pubertal children. We retrospectively reviewed patient charts of those 16 years and younger, diagnosed with pseudotumor cerebri/idiopathic intracranial hypertension. Our study group consisted of 27 patients; the mean age was 10.9 years, and there was a male-to-female ratio of 13 to 14. In the prepubertal group (n = 13), the male-to-female ratio was 8 to 5; in the pubertal group, (n = 14), the ratio was 5 to 9. Overweight or obesity was found in 16 (59%) patients. Outcome was favorable except for one who remained symptomatic. Pseudotumor cerebri/idiopathic intracranial hypertension in children is rare. Its characteristics differ from adults. We found the prepubertal group to be a distinct group since pseudotumor cerebri/idiopathic intracranial hypertension did not occur predominantly in females and was not associated with obesity.
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PMID:Idiopathic intracranial hypertension in the pediatric population. 1288 85

An 11-year-old boy with recurrent nephritis due to tubulointerstitial nephritis associated with uveitis (TINU syndrome) was treated with cyclosporin A (CSA) to induce sustained remission. CSA was introduced as a steroid-sparing drug because of extreme obesity (body mass index 32 kg/m(2)). Although the boy did not complain of any clinical symptoms, eye inspection after 7 months revealed bilateral disk edema with retinal bleeding and the patient developed cerebrospinal hypertension. Pseudotumor cerebri was diagnosed by measuring the intracranial pressure (31 cm H(2)O) and normal computer tomography and brain magnetic resonance imaging. Cessation of CSA therapy and treatment with mycophenolate mofetil led to resolution within 12 weeks.
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PMID:Pseudotumor cerebri following cyclosporine A treatment in a boy with tubulointerstitial nephritis associated with uveitis. 1501 64

Idiopathic intracranial hypertension (IIH) is the syndrome of raised intracranial pressure without clinical, laboratory or radiological evidence of intracranial pathology. IIH is a relatively rare disease but rapidly increasing incidence is reported due to a global increasing incidence of obesity. Disease course is generally said to be self-limiting within a few months. However, some patients experience a disabling condition of chronic severe headache and visual disturbances for years that limit their capacity to work. Permanent visual defects are serious and not infrequent complications. The pathophysiology of IIH is still not fully understood. Advances in neuroimaging techniques have facilitated the exclusion of associated conditions that may mimic IIH. No causal treatment is yet known for IIH and existing treatment is symptomatic and rarely sufficient. The aim of this review is to provide an updated overview of this potentially disabling disease which may show a future escalating incidence due to obesity. Theories of pathogenesis, diagnostic criteria and treatment strategies are discussed.
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PMID:What is new about idiopathic intracranial hypertension? An updated review of mechanism and treatment. 1655 39

Pseudotumor cerebri is a disease characterized by increased intracranial pressure, often manifested by headaches, and occasionally leading to severe visual impairment or even blindness. Most cases in adolescents, as in adults, are associated with obesity. We report a 16-year-old morbidly obese adolescent girl (body mass index 42.3 kg/m(2)) with severely symptomatic pseudotumor cerebri who had progressive visual field deficits and elevated intracranial pressure (opening pressure on lumbar puncture of 50 cm H(2)O) despite intensive medical management and placement of both ventriculoperitoneal and lumboperitoneal shunts. Six months after she underwent gastric bypass surgery, she had lost 43% of her excess body weight and had had near complete regression of her visual field deficits, along with normalization of her intracranial pressures. This case demonstrates the dramatic reversal of symptoms of pseudotumor cerebri with surgically induced weight loss. Gastric bypass should be considered as a treatment option for adolescents with severe and progressive pseudotumor cerebri.
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PMID:Clinical resolution of severely symptomatic pseudotumor cerebri after gastric bypass in an adolescent. 1732 34

Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, is a disorder of elevated intracranial pressure of unknown cause. Patients present with daily headache, pulse-synchronous tinnitus, transient visual obscurations, papilledema with its associated visual loss, and diplopia from sixth nerve paresis. Many disease associations have been alleged, but few besides obesity, hypervitaminosis A and related compounds, steroid withdrawal, and female gender have been proven. Although absorption of cerebrospinal fluid (CSF) occurs through arachnoid granulations and extracranial lymphatics, outflow resistance is increased in IIH; therefore, intracranial pressure must increase for CSF to be absorbed. The mainstays of medical treatment are a reduced-sodium weight-reduction program and acetazolamide. If patients fail medical therapy, surgical procedures, most commonly optic nerve sheath fenestration and CSF shunting, are employed. The main morbidity of IIH is visual loss. This is present in most patients and can usually be reversed if recognized early in the course of the disease and treated.
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PMID:Idiopathic intracranial hypertension (pseudotumor cerebri). 1846 Feb 75

Pseudotumor cerebri occurs quite rarely in the pediatric population and its clinical features differ from adults in many ways. Intracranial hypertension with papilledema should obviously be treated promptly to avoid permanent visual damage, but various more or less invasive options have been proposed over the years, from bariatric surgery for obesity to optic nerve sheath fenestration. We report a prospective study on a group of 15 children, aged 3-16 years, with clinical and instrumental diagnosis of pseudotumor cerebri. All the patients were treated simply by external lumbar cerebrospinal fluid drainage with a mean volume of 10 ml/h for 3-5 days, with hypocaloric diet and with appropriate dosages of acetazolamide. All had immediate relief of headache, a considerable reduction in papilledema and marked improvement of both visual loss and cranial nerve palsies within 2 months. None of the patients relapsed during the follow-up period, ranging from 12-48 months.
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PMID:Pseudotumor cerebri in pediatric age: role of obesity in the management of neurological impairments. 1851 Aug


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