Loulwah Mukharesh, MD, Marc A. Bouffard, MD, Elizabeth Fortin, MD, David H. Brann, Sandeep Robert Datta, MD, PhD, Sashank Prasad, MD, Bart K. Chwalisz, MD (2023)

Pseudotumor Cerebri Syndrome With COVID-19: A Case Series

Journal of neuro-ophthalmology, Volume 42, Issue 3

Pseudotumorcerebrisyndrome (PCS) either affects mostly overweight women of childbearing age as idiopathic intracranial hypertension (IIH) or can occur secondary to other medical conditions. Symptoms include headaches, transient visual obscurations(TVOs), pulse-synchronous tinnitus (PST), and vision loss. Diagnosis rests on increased intracranial pressure (ICP) without alternative explanation such as intracranial mass, meningitis, or cerebral venous sinus thrombosis (CVST). COVID-19 is a global pandemic caused by infection with the severe acute respiratory syndrome coronavirus2 (SARS-CoV2). We describe an association between PCS and COVID-19 in adult patients. Potential mechanisms include dysregulation of cerebrospinal fluid (CSF) dynamics in the setting of choroid plexus epithelium and meningeal infection, venous clotting, or quarantine-related lifestyle modifications promoting weight gain. In this study, we report 8 patients (See Supplemental Digital Content, Table 1, http://links.lww.com/WNO/A536) who developed new or worsening PCS shortly after acquiring COVID-19 without meningoencephalitis or major CVST and mostly without significant recent weight gain.