Pseudotumor Cerebri Associated With Prolonged Corticosteroid Therapy

Abstract

An endocrine factor appears to be one of the causes of benign intracranial hypertension. The occurrence of the pseudotumoral syndrome has been seen in children receiving corticosteroids over prolonged periods of time for various conditions. The clinical manifestations of headache, nausea, vomiting, and papilledema tend to occur during the reduction or withdrawal phase of therapy. The blood electrolyte levels are normal but urinary steroid excretion may be low. Although the cerebrospinal fluid pressure is elevated, the ventricles may be small. A transient hypophyseal adrenal suppression appears to be an underlying mechanism. The condition is usually self-limited with appropriate management. The authors review the clinical features of the reported cases and of four patients seen at the Johns Hopkins Hospital.