Cognitive Impairment in patients with Pseudotumor Cerebri Syndrome

  • Kharkar S
  • Hernandez R
  • Batra S
 et al. 
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Abstract. Introduction: Patients with Pseudotumor Cerebri Syndrome (PTCS) may complain of difficulty in thinking or concentrating; however there has been little formal cognitive evaluation in this population.
Objective: To evaluate the characteristics and nature of cognitive impairment in patients with PTCS.
Methods: We retrospectively reviewed records of 10 patients diagnosed with PTCS who were cognitively tested at presentation. In each cognitive test, “Borderline deficit” (BD) was defined as a score more than 1 standard deviation (SD) below and “Definite Deficit” (DD) as a score more than 2 SD below the mean for age, sex and education. In each cognitive domain, impairment was defined as a single test score more than 2 SD below the mean, or scores of more than 1 SD below the mean for age, sex and education in > 50% of tests.
Results: Mean age of patients was 43.4 ± 13.5 years. 8/10(80%) patients were female. 3/10(30%) had papilledema; 3/10(30%) had significant cerebral venous outflow obstruction. Impairment was most commonly seen and was most severe in the WMS
logical memory I (BD44%, DD44%), WMS logical memory II (BD37.5%, DD50%),
RAVLT delayed recall (BD30%, DD40%)
and RAVLT retention(BD40%, DD30%)
tests. Evaluation of cognitive domains revealed impairment in memory and learning (80%), executive function (10%), visuospatial skills (30%), and language (30%).
Conclusion: Our results indicate that patients with PTCS can have significant cognitive impairment, particularly in learningand memory. The prevalence needs to be studied in a larger cohort. The relationship of cognitive impairment with chronically elevated intracranial pressures and its role in contributing to patient morbidity needs to be investigated further.

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  • S. Kharkar

  • R. Hernandez

  • S. Batra

  • P. Metellus

  • A. Hillis

  • M. A. Williams

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