Pseudotumor Cerebri Syndrome Without Papilledema

Abstract

An obese, young woman exhibited the classical features of pseudotumor cerebri syndrome, including increased intracranial pressure, normal cerebrospinal fluid and ventricular system, and absence of focal neurologic signs. Despite elevated intracranial pressure of sufficient magnitude to produce bilateral sixth-nerve palsy, papilledema did not develop. The illness resolved spontaneously and on examination 1 1/2 years later, the patient was normal. There are several possible mechanisms that might prevent papilledema from developing under these circumstances.