Medical Minute 4-7: Pseudo Tumors

By: Ramin Khalili Email
By: Ramin Khalili Email

Little Zoe Ladybug is dolled up and ready for her close-up. Taking pictures of her model pup is Lauren Ashley's passion, but this teen has to fight through daily pain to perform her photo shoots.

"She's had a headache since she was five," said Lauren's mother Diane.

Lauren takes 22 pills a day. She's had over 30 surgeries and has been in the hospital more than 50 times. It's a lot for a 16-year-old to deal with.

"I had to be admitted because I had suicidal thoughts…and everything was just really bad," said Lauren.

Lauren has a condition known as pseudo tumor cerebri. It happens when there's too much pressure inside the skull.The result: Severe headaches, dizziness and neck and back pain.

"The general consensus is we're either seeing more children with pseudo tumor or we've gotten better at recognizing it," said E. Steve Roach, M.D., Pediatric Neurologist at Nationwide Children's Hospital.

It's called "pseudo-tumor" because it's often mistaken for a brain tumor - but scans show nothing's there. If the pressure build up is untreated, it can lead to blindness and other neurological problems.

"Unfortunately, one of the reasons children are overlooked is because people just don't think of it," said Dr. Roach.

There are drugs to treat the condition. A shunt placed in a patient's head can drain extra spinal fluid in the skull. Optic nerve surgery can protect the eyes from pressure buildup.

Lauren had eye surgery and a shunt procedure. Her pain is much less and she's thankful she has her sight -- it's what lets her do what she loves.

For more information on other series produced by Ivanhoe Broadcast News contact John Cherry at (407) 691-1500,


BACKGROUND: Pseudo-tumors, or pseudotumor Cerebri, occurs when the pressure inside the skull increases for no apparent reason, resulting in brain tumor-like symptoms when no tumor actually exists. Though the causes of pseudotumor cerebri are largely unknown, doctors believe it can be caused by a build-up of cerebrospinal fluid in the skull. Pseudo-tumors affect one person out of every 100,000 in the general public. (SOURCE:

SYMPTOMS: Symptoms of a pseudo-tumor are moderate to severe headaches that worsen with eye movement, neck, shoulder or back pain, a ringing in your ears that pulses in time with your heartbeat, nausea or dizziness, and vision problems, including blurred or dimmed vision, seeing light flashes, double vision and brief (only a few seconds long) periods of blindness. Even though the symptoms can be resolved, they can return months or years later. (SOURCE:

RISK FACTORS: Pseudo-tumors are most common in obese women of child-bearing age: obese women under 44 are 20 times more likely to develop a pseudo-tumor than the average person. Though recent evidence has shown most people with pseudo tumors also have a narrowing of two large sinuses in the brain, a causal relationship has yet to be established. People taking certain medications, such as growth hormones, oral contraceptives, or excess vitamin A are at an increased risk, as are people who are obese or have conditions such as Addison's disease, mononucleosis, lupus and Lyme disease. Pseudo-tumors are also on the rise among children; doctors suspect the rise in childhood obesity may be to blame. (SOURCE:,

DIAGNOSIS AND TREATMENT: Pseudo-tumors are usually diagnosed via an eye exam, brain imaging, or a spinal tap. In an eye exam, the doctor will look for a specific type of swelling in the back of your eye (called papilledema) and will test for blind spots in your field of vision. An MRI or CAT scan can rule out actual tumors or blood clots that might be causing the symptoms, and a spinal tap (or lumbar puncture) can determine the amount of pressure in the skull. Once the pseudo-tumor has been diagnosed, several medications, such as migraine medications, glaucoma drugs or diuretics (to reduce fluid retention and drain the excess fluid in the skull) can be used to treat the symptoms. However, if symptoms persist, surgery is another option. One procedure, called optic nerve sheath fenestration, cuts a window into the membrane surrounding the optic nerve in order to let the cerebrospinal fluid escape. The other procedure is called a spinal fluid shunt: a long thin tube (the shunt) is inserted into the brain or lower back and drains away the excess cerebrospinal fluid. (SOURCE:

For More Information, Contact:
Erin Pope
The Ohio State University College of Medicine
(614) 562-1382

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