Affiliations: Department of Neurology, Johns Hopkins School of
Medicine, Baltimore, MD, USA | Department of Neurosurgery, Johns Hopkins School of
Medicine, Baltimore, MD, USA | Adult Hydrocephalus Program, Johns Hopkins Hospital,
Baltimore, MD, USA
Note: [] Corresponding author: Dr. Daniele Rigamonti, Phipps 126, 600
North Wolfe St, Baltimore, MD 21287, USA. Tel.: +1 410 955 2259; Fax: +1 410
955 9126; E-mail: dr@jhmi.edu
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
(BD-44%, DD-44%), WMS logical memory II (BD-37.5%, DD-50%), RAVLT
delayed recall (BD-30%, DD-40%) and RAVLT retention(BD-40%, DD-30%)
tests. Evaluation of cognitive domains revealed impairment in memory and
learning (80%), executive function (10%), visuo-spatial skills (30%),
and language (30%). Conclusion: Our results indicate that patients
with PTCS can have significant cognitive impairment, particularly in learning
and 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.
