psuedotumor cerberi

i have benn dignoased with psuedotumor cerebri  for the last 3 years nowand just recentlly my pressure has been fine lp was 15 closing was 3 but there is a problem from my last lp i been having alot of pressure behind my eyes and don't now what it is can you help me through all this

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

Benign intracranial hypertension, also called pseudotumor cerebral, or idiopathic intracranial hypertension, is a disorder characterized clinically by headaches and vision loss, and sometimes tinnitus (ringing in the ear that is synchronous with the pulse). Dizziness may also be a symptom. The headache is usually global (all over the head) and pressure-like; the headache presentation can be variable. BIH predominantly occurs in people who are overweight, women, and those taken specific medications such as retin-A (the acne medication), vitamin A, and tetracycline antibiotics.

It is diagnosed based on clinical findings and the finding of a high cerebrospinal fluid pressure on lumbar puncture. Other tests may include specific types of brain MRIs and an MRV. The treatment is usually with medications to decrease the amount of fluid around the brain and these are mainly diuretics though other medications are also used. Patients who do not respond to medications or who have vision loss require procedures to relieve the cerebrospinal fluid pressure or at least the pressure around the nerves to the eye (to prevent vision loss). If a problem with the veins in the brain (cerebral venous stenosis is found), treatment for this may be indicated as well.

If headaches/head pressure have worsened following the LP, another possible cause is that there was over-draining, or persistent leakage of CSF, leading to too low of a pressure that can also lead to headaches. The headaches related to over-draining classically improve when the person lies down and gets worse when the person sits or stands.

It is very important to follow-up with your eye doctor if there is concern of pressure on your optic nerves, and ideally be evaluated by a neuro-opthalmologist (an eye doctor specialized in neurologic disorders involving the eyes), to ensure your visual fields are not being impaired due to the papilledema, because chronic pressure on the optic nerves can lead to permanent vision loss. Continued follow-up with your neurologist is recommended as well.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.