PURPOSE: Demographic and outcome data in the era of modern neuroimaging are 
needed to describe pseudotumor cerebri in children.
METHODS: We reviewed the medical records of children less than 18 years old who 
were diagnosed with pseudotumor cerebri between 1977 and 1997. We defined 
pseudotumor cerebri as (1) increased intracranial pressure, (2) normal or small 
ventricles, and (3) normal cerebrospinal fluid composition. The condition might 
be idiopathic or the result of a nontumor etiology.
RESULTS: Thirty-seven patients had an initial diagnosis of pseudotumor cerebri. 
Two patients were subsequently diagnosed with a central nervous system 
malignancy and were excluded from further analysis. The remaining 35 patients 
included 10 patients with idiopathic pseudotumor cerebri and 25 patients with 
disorders reported to be associated with pseudotumor cerebri. The mean age was 
10.6 years with a range of 3 to 17 years. Twenty patients (57%) were female and 
13 patients (37%) were obese. At presentation 4 patients had a visual acuity 
less than 20/40 in the best eye and 10 patients had visual field deficits. 
Seventeen patients (49%) had cranial nerve deficits, all of which resolved with 
normalization of the intracranial pressure. Follow-up data were obtained on 30 
patients. Only one patient had a final visual acuity less than 20/40 in the best 
eye, whereas six patients had residual visual field deficits. Ten patients (33%) 
had optic nerve atrophy.
CONCLUSIONS: There was no gender predominance, and associated etiologic factors 
were common in these children with pseudotumor cerebri. Permanent visual loss 
occurs in some children with pseudotumor cerebri. Quantitative perimetry and 
optic nerve examination were more sensitive than visual acuity determination in 
detecting damage to the visual sensory system. In rare instances the patient 
diagnosed with pseudotumor cerebri will be found after extended follow-up to 
harbor an intracranial neoplasm.