Treatments and drugs

By Mayo Clinic Staff

The goal of pseudotumor cerebri treatment is to improve your symptoms and keep your eyesight from worsening. Your doctor may prescribe medications to control your symptoms.

If you're obese, your doctor will recommend weight loss. You may work with a dietitian to help with your weight-loss goals. Losing weight may improve your symptoms. Some people who are morbidly obese may benefit from weight-loss programs or gastric surgery to lose weight.

If your vision worsens, surgery to reduce the pressure around your optic nerve or to decrease the intracranial pressure may be necessary. Once you've had pseudotumor cerebri, you should have your vision checked regularly.

Medications

  • Glaucoma drugs. One of the first drugs usually tried is acetazolamide (Diamox), a glaucoma drug. This medication may reduce the production of cerebrospinal fluid. Also, it has been shown to improve symptoms in 47 to 67 percent of people.

    Possible side effects include stomach upset, fatigue, tingling of fingers, toes and mouth, and kidney stones.

  • Diuretics. If acetazolamide alone isn't effective, it's sometimes combined with furosemide (Lasix), a potent diuretic that reduces fluid retention by increasing urine output.
  • Migraine medications. Medications usually prescribed to relieve migraines can sometimes ease the severe headaches that often accompany pseudotumor cerebri.

Surgery

  • Optic nerve sheath fenestration. In this procedure, a surgeon cuts a window into the membrane that surrounds the optic nerve. This allows excess cerebrospinal fluid to escape.

    Vision stabilizes or improves in most cases. Most people who have this procedure done on one eye notice a benefit for both eyes. However, this surgery isn't always successful and may even increase vision problems.

  • Spinal fluid shunt. In another type of surgery, your doctor inserts a long, thin tube (shunt) into your brain or lower spine to help drain away excess cerebrospinal fluid.

    The tubing is burrowed under your skin to your abdomen, where the shunt discharges the excess fluid. Symptoms may improve for some people who undergo this procedure.

    However, shunts can become clogged and often require additional surgeries to keep them working properly. Complications can include low-pressure headaches and infections.

    This procedure is generally only a treatment option if other treatments haven't relieved your condition.

Feb. 01, 2014

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