Treatment

The goal of pseudotumor cerebri treatment is to improve your symptoms and keep your eyesight from worsening.

If you're obese, your doctor might recommend a low-sodium weight-loss diet to help improve your symptoms. You might work with a dietitian to help with your weight-loss goals. Some people benefit from weight-loss programs or gastric surgery.

Medications

• Glaucoma drugs. One of the first drugs usually tried is acetazolamide, a glaucoma drug. This medication might reduce the production of cerebrospinal fluid and reduce symptoms.

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

• Other diuretics. If acetazolamide alone isn't effective, it's sometimes combined with another diuretic, which reduces fluid retention by increasing urine output.
• Migraine medications. These drugs can sometimes ease the severe headaches that often accompany pseudotumor cerebri.

Surgery

If your vision worsens, surgery to reduce the pressure around your optic nerve or to decrease the intracranial pressure might be necessary.

• Optic nerve sheath fenestration. In this procedure, a surgeon cuts a window into the membrane that surrounds the optic nerve to allow 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 can 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 excess cerebrospinal fluid. The tubing is burrowed under your skin to your abdomen, where the shunt releases the excess fluid.

  A shunt is generally considered only if other treatments haven't relieved your condition. Shunts can clog and often require other surgeries to keep them working. Complications can include low-pressure headaches and infections.

• Venous sinus stenting. This relatively new procedure is rarely used. It involves placing a stent in one of the larger veins in the head to increase the blood's ability to flow. More study is needed to determine the benefits and risks of this procedure.

Once you've had pseudotumor cerebri, you'll need to have your vision checked regularly to monitor changes.