Transcription of Expert Opinion - rwevansmd.com
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Expert Opinion - rwevansmd.com
Expert Opinion 495 The Management of Pseudotumor Cerebri During Pregnancy Case Histories Submitted by Randolph W. Evans, MD Expert Opinion by Deborah I. Friedman, MD Key words: pseudotumor cerebri, pregnancy, lumbar punctureAbbreviations: PTC pseudotumor cerebri ( Headache 2000;40:495-497) The management of pseudotumor cerebri (PTC)in pregnancy, while not a common problem, raisesseveral difficult issues. CLINICAL HISTORY This 20-year-old woman developed mild headachesand was found to have papilledema in December height was 5 9 4 0 , and her weight was 205 lb. A neu-rologist and an ophthalmologist diagnosed pseudotu-mor cerebri after an evaluation that included a magneticresonance imaging (MRI) scan of the brain with normalfindings, a lumbar puncture revealing an opening pres-sure of 31 cm of water, and a normal cerebrospinal fluid(CSF) examination, except for a decreased proteinlevel. She was prescribed acetazolamide (Diamox), 500mg twice daily. When I saw her in September 1999, shewas 5 months pregnant and had continued taking theacetazolamide throughout the pregnancy.
Headache 497 Invitation to Submit Clinical Dilemmas The “Expert Opinion” section of Headache is edited by Randolph W. Evans, MD, who invites readers to submit clinical problems, case reports,
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