Pseudotumor cerebri is an idiopathic disorder characterized by papilledema and 
elevated intracranial pressure without a mass lesion. Most patients are female 
and young and are either overweight or have a history of recent weight gain. 
Other disease states, such as systemic lupus erythematosus, and drugs, such as 
tetracycline, have also been associated with the development of pseudotumor 
cerebri. The mechanism is unclear, but is likely related to decreased 
cerebrospinal fluid (CSF) resorption. Almost all patients have headache, but the 
greatest morbidity of the disorder is visual loss related to optic disc 
swelling. Common radiographic findings in pseudotumor cerebri include an empty 
sella, dilation of the optic nerve sheaths and elevation of the optic disc. The 
CSF, aside from elevated opening pressure, is normal without evidence of 
infection or inflammation. Treatment of patients with no or mild to moderate 
visual loss is primarily medical, with acetazolamide as the first-line agent. 
Acetazolamide decreases CSF production. Furosemide and corticosteroids are 
secondary choices. Optic nerve surgery is reserved for patients with severe 
visual loss or progression in visual deficits despite medical management.