NCI CPTC Antibody Characterization Program, Mao L, Jin H, Wang M, et al. In four patients, there was a previous history of migraine without aura. Unilateral papilledema in 'benign' intracranial hypertension (pseudotumor cerebri). 1 SARS-CoV-2 and Hypertension: Evidence Supporting Invasion into the Brain Via Baroreflex Circuitry and the Role of Imbalanced Renin-Angiotensin-Aldosterone-System. Median values for cell counts, glucose, and protein were of 1.6/mm3 (1-4/mm3), 55.6mg/dL (3871mg/dL), and 29.6mg/dL (1545mg/dL), respectively. Cerebral venous sinus thrombosis (CVST) among patients with COVID-19 can also occur with an abnormally activated prothromboplastin time (aPTT) and elevated D-dimer levels. COVID-19 and benign intracranial hypertension: A case report. How do I protect a family member who has a condition or is taking medications that weaken their immune system? The cause of pseudotumor cerebri is unknown. The most relevant were acute cerebrovascular disease in 5.7%, impaired consciousness in 14.8%, and skeletal muscle injury in 19.3%. Air Med J. The spread of new variants can also increase the risk of reinfection. Epub 2020 Jul 10. Herein, we describe the characteristics of headache and the CSF profile during SARS-CoV-2 infection in a consecutive series of COVID-19 patients, highlighting the cases associated with isolated intracranial hypertension. 2020;19:767783. These are signs of pseudotumor cerebri. Learn how this disease affects the nervous system. official website and that any information you provide is encrypted However, the additional protective measures such as the use of a face shield and the close contact with patients during this exam impose additional difficulties to physicians evaluating COVID-19 patients with headache. Authors . Ravid S, Shachor-Meyouhas Y, Shahar E, et al. The .gov means its official. *NCCN is a nonprofit alliance of 31 leading cancer centers devoted to patient care, research, and education. Write your doctors numberon your notebook should a technical issue arise. https://doi.org/10.1101/2020.10.22.349415. The Local Ethical Committee at INI/FIOCRUZ approved this study. https://www.uptodate.com/contents/search. National Library of Medicine FN: Conception and design of the study, acquisition of data, drafting the article, final approval of the version to be submitted; EM: Conception and design of the study, drafting the article; FMC: Analysis and interpretation of data. In addition, COVID-19 vaccination might offer better protection than getting sick with COVID-19.A recent study showed that unvaccinated people who already . The patient was treated with supportive measures and nasal oxygen. COVID-19 and benign intracranial hypertension: A case report. From April to May 2020, we retrospectively selected all consecutive inpatients with SARS-CoV2 infection from different centers who underwent lumbar puncture due to different neurological symptoms. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). You canview the NCCN COVID-19 vaccination guide for people with cancerfor additional information. Unable to load your collection due to an error, Unable to load your delegates due to an error. But they continue to focus on caring for patients who are already in trials. It is important to understand that pseudotumor literally means "false tumor," as it is a condition that only . official website and that any information you provide is encrypted Viral-induced intracranial hypertension mimicking pseudotumor cerebri, Primary varicella infection presenting with headache and elevated intracranial pressure. But it's not a tumor. Your body constantly makes cerebrospinal fluid. Getting treated as soon as possible can help you keep your vision. If so, consider these precautions: You may see restrictions at your treating hospital to protect patients and staff. 8600 Rockville Pike However, no detailed information on headache characteristics is provided in these reports. It is increasingly recognized that PTC can also affect memory and cognition. At Another Johns Hopkins Member Hospital: Normal Pressure Hydrocephalus: Patricia's Story. PMC 1Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Rio de Janeiro, RJ, Brasil. Watch the CDCs educational video What You Need to Know About Variants to learn more. COVID-19 is a novel form of a large family of viruses called coronaviruses. Rev Soc Bras Med Trop. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. Headaches may be accompanied by a "whooshing" sound or ringing in the ears. Be extra vigilant about hand hygiene and not touching your face. 2Hospital Copa DOr, Rede DOr So Luiz, Servio de Neurologia, Rio de Janeiro, RJ, Brasil. As a library, NLM provides access to scientific literature. Mayo Clinic does not endorse companies or products. Coronavirus; Covid-19 Vaccine; Race and Medicine; Climate Crisis and Health; Frontiers in Medicine; Data Sharing; Pain Management; Optic nerve sheath diameter is associated with outcome in severe Covid-19. Patients with Pseudotumor Cerebri typically experience headaches and episodes of blurred vision. According to theNCI, the effect of the COVID-19 pandemic on trials varies depending on where you live. All patients had normal cell counts and glucose and protein levels on the CSF analysis. Other times, new variants persist. This website uses cookies that help the website function and that help us understand how you interact with it. Moderate, daily, non-throbbing headache, without other features. Epub 2022 Apr 27. Krishnakumar D, Pickard JD, Czosnyka Z, et al. *This patient appears in case description in the section Results of this manuscript. Yang AC, Kern F, Losada PM, Maat CA, Schmartz G, Fehlmann T, Schaum N, Lee DP, Calcuttawala K, Vest RT, Gate D, Berdnik D, McNerney MW Broad transcriptional dysregulation of brain and choroid plexus cell types with COVID-19. Most of the time there is no obvious cause for the increased pressure. BIH (pseudotumor cerebri) is a clinical condition that includes headache, papilledema, increased blood pressure, and clear cerebrospinal fluid1. Pseudotumor cerebri (PTC), also known by the name idiopathic intracranial hypertension (IIH), is a disorder with increased intracranial pressure (ICP) and associated headaches, papilledema, vision changes, or pulsatile tinnitus in the setting of normal imaging and cerebrospinal fluid (CSF) studies. Read the latest issue. Headache and pleocytosis in CSF associated with COVID-19: case report. According to thePublic Health Communications Collaborative, along with getting vaccinated and boostered, experts recommend upgrading your mask if you want optimal protection. What should I do about getting treatment? Brain and orbital MRI were normal except for discrete white matter lesions in the pons and the cerebral hemispheres suggestive of small vessel disease best observed on T2/FLAIR sequences. We analysed those who presented refractory headaches with or without visual symptoms as the predominant neurological complaints and excluded those who presented any clinical or laboratory evidence for meningitis or meningoencephalitis, such as neck stiffness, altered consciousness, focal neurological signs, or inflammatory characteristics in the CSF analysis. Thus, a low-grade inflammation determined by SARS-CoV-2 infection in conjunction with this hyperviscosity and hypercoagulable state could result in intracranial hypertension in some infected individuals. Headaches associated with this disorder may vary from person to person. Neurol India. MeSH This fluid surrounds your brain and spinal cord and protects them from injury. It can be hard to tell a pseudotumor from a real tumor. In a significant proportion of COVID-19 patients, headache was associated to intracranial hypertension in the absence of meningitic or encephalitic features. In this study, 56 consecutive COVID-19 patients underwent lumbar puncture for different neurological conditions during the SARS-CoV-2 infection, and 13 of these (23.2%) had a new, persistent headache that prompted a CSF analysis. Fifty-six COVID-19 patients underwent lumbar puncture for different neurological conditions. Fundoscopy was impaired. Support. Unauthorized use of these marks is strictly prohibited. The site is secure. The optic nerve head OCT B scans show elevation of the optic disc in both eyes ((a) and (b)). CSF oligoclonal bands were not present, and serum anti-NMO (CBA method) was negative. eCollection 2023. In addition, the involvement of the facial nerve has been associated with SARS-CoV-2 infection, but generally in the context of Guillain-Barr syndrome (34,35). Headache and impaired consciousness level associated with SARS-CoV-2 in CSF: A case report. Lee AG, et al. Revista da Sociedade Brasileira de Medicina Tropical. Pansell J, Rudberg PC, Bell M, Friman O, Cooray C. Sci Rep. 2022 Oct 14;12(1):17255. doi: 10.1038/s41598-022-21311-3. Pseudotumor cerebri occurs when the pressure of the cerebrospinal fluid (CSF) inside of your skull increases with no apparent cause. No focal deficit, ataxia, or pupil light response abnormalities were found on the neurological examination. Treatment depends on what is causing the fluid to build up inside the skull. Please enable it to take advantage of the complete set of features! To our knowledge, this is the first report of COVID-19 associated with isolated BIH. -, Shi H, Han X, Jiang N, et al. Chemotherapy and radiation can compromise a patients immune system, making them more susceptible to COVID-19. Idiopathic intracranial hypertension (pseudotumor cerebri). official website and that any information you provide is encrypted CSF opening pressure ranged from 150 to 600mmH2O (median of 270mmH2O). Coagulopathy associated with COVID-19 could be an explanation, but further studies including post-mortem analysis of areas of production and CSF absorption (choroid plexuses and arachnoid granulations) are necessary to clarify this issue. Unable to load your collection due to an error, Unable to load your delegates due to an error. NCCN COVID-19 Vaccination Guide for People With Cancerstates that people with cancer should continue to follow the recommendations to prevent COVID-19. Pseudotumor cerebri syndrome associated with MIS-C: a case report. Spectrum of Neurological Manifestations in Covid-19: A Review. Brain Sci. Marcus Tulius T Silva, Laboratory of Clinical Research in Neuroinfections (LAPCLIN-NEURO), Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Avenida Brasil, 4365 Manguinhos, Rio de Janeiro 21040-900, Brazil. Other symptoms may include: Vision changes (like double vision) or vision loss Dizziness, nausea and/or vomiting Neck stiffness Persistent ringing in the ears (tinnitus) Prospective, Cross-Sectional Study Finds No Common Viruses in Cerebrospinal Fluid of Children with Pseudotumor Cerebri. 2020; 77: 683690. If telemedicine is an option for you, below are sometips and suggestions for preparing for a virtual appointment: For more information visit: National Cancer Institute (NCI) What should I do about getting treatment? -, Chen N, Zhou M, Dong X, et al. Sometimes new variants emerge and disappear. Substances linked to secondary intracranial hypertension include: Conditions and diseases that have been linked to secondary intracranial hypertension include: For some people with pseudotumor cerebri, their vision continues to worsen, leading to blindness. Careers. Before This site needs JavaScript to work properly. Pseudotumor cerebri syndrome and essential thrombocythaemia: Case report and literature review. 2020 Jun 8;53:e20200325. Because pseudotumor cerebri can come back, see your doctor for follow-up visits and get regular eye checkups. (IIH) (pseudotumor cerebri) Posted on October 21, 2021 November 28, 2022 by Ivan Wolansky. But if too much fluid is produced or not enough is re-absorbed, the CSF can build up and cause pressure within the skull, which is an enclosed space. Neurol Clin. The fluid that surrounds the spinal cord and brain is called cerebrospinal fluid or CSF. 2020; 382: 17081720. 2001 Mar;14(1):129-47, ix. Most people completely recover, but a few will have permanent vision loss. FDA simplifies COVID vaccine dosing; all mRNA vaccines will be bivalent. Medications often can reduce this pressure and the headache, but in some cases, surgery is necessary. Latest Health News Video COVID-19 Vaccine COVID-19 Seasonal Flu. Brain venous MRI found no evidence of cerebral venous thrombosis. Intracranial venous thrombosis has been implicated as a cause for intracranial hypertension secondary to CSF outflow obstruction (29). In this cross-sectional study, we selected COVID-19 patients who underwent lumbar puncture due to neurological complaints from April to May 2020. After two days of hospitalization, the patient returned to a normal level of consciousness and the headache disappeared. reflecting antibody dynamics of vaccine- and infection-induced immune response, and . Pseudotumor cerebri (SOO-doe-too-mur SER-uh-bry) occurs when the pressure inside your skull (intracranial pressure) increases for no obvious reason. Lancet. Accessed July 31, 2019. The symptoms of pseudotumor cerebri can get worse and hurt your vision. According to the CDC, the virus that causes COVID-19 is constantly changing, and new variants of the virus are expected to occur. Placement of a stent in the draining venous sinuses if narrowed, to improve CSF absorption and reduce intracranial pressure. The fluid drainage can give some individuals immediate, but temporary, relief of their headache and other symptoms, but this response alone, without signs of elevated pressure or eye problems, is not conclusive evidence that pseudotumor cerebri is the problem. Please enable it to take advantage of the complete set of features! MRI showed multiple small hyperintense foci. 2022. Dolhnikoff M, Duarte-Neto AN, de Almeida Monteiro RA, et al. Excess weight: Body weight is the most significant preventable pseudotumor cerebri risk factor, although thin people can develop the disorder. Neurotox Res. Practiceby taking five minutes to do a run-through with equipment, the space where you will be, and lighting. Cognitive function in idiopathic intracranial hypertension: A prospective case-control study, Idiopathic intracranial hypertension and seventh nerve palsy, Idiopathic intracranial hypertension and facial diplegia, Facial diplegia, a possible atypical variant of Guillain-Barr Syndrome as a rare neurological complication of SARS-CoV-2. Pathogenic mechanisms, including endothelial dysfunction with increased levels of von Willebrand factor, systemic inflammation with Toll-like receptor activation, and a procoagulatory state via tissue factor pathway activation, are involved (28). In addition, patients with headache and elevated opening pressure on lumbar puncture but no papilledema have been described (1721). In places with many more COVID-19 cases, some sites may have stopped enrolling new patients for a while. FOIA Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: A descriptive study. Ask your health care providers and caregivers to wash their hands before treating you. In: Ferri's Clinical Advisor 2020. Lee AG, et al. This is the first case of idiopathic intracranial hypertension associated to SARS-CoV-2 probably due to immune-mediated process, and the treatment with corticosteroids and acetazolamide was effective. Elsevier 2019. https://www.clinicalkey.com. Medicine and surgery are the main treatments for pseudotumor cerebri. Headache. The pain was throbbing, holocranial or bilateral in the majority of patients. An official website of the United States government. Idiopathic intracranial hypertension. Eggenberger ER (expert opinion). The opening CSF pressure of one of these patients with papilledema was 210mmH2O, below the level required for the diagnosis of pseudotumor cerebri syndrome (PTCS), according to a revised diagnostic criteria (12). Email: Received 2020 Jun 12; Revised 2020 Jul 30; Revised 2020 Sep 8; Accepted 2020 Sep 23. After visiting 30+ physicians, Ashley was diagnosed with the rare condition known as pseudotumor cerebri. Subscribe to AAP News. We study 5,004 people who take Trelstar depot or have Pseudotumor cerebri. An official website of the United States government. Corbett JJ. eCollection 2020. de Oliveira FAA, Palmeira DCC, Rocha-Filho PAS. Advertising revenue supports our not-for-profit mission. This is an open-access article distributed under the terms of the Creative Commons Attribution License. Lancet 2020; 395: 507513. Funding: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by Fundao Oswaldo Cruz, Minister of Health, Brazilian Government. Pseudotumor Cerebri Syndrome With COVID-19: A Case Series J Neuroophthalmol. Before National Library of Medicine Cephalalgia. Covid 19 Associated Idiopathic Intracranial Hypertension and Acute Vision loss. No other causes for intracranial hypertension, such as obesity, venous thrombosis, or drugs, were identified in these patients. The normal value of CSF pressure in an appropriate clinical setting could be a matter of debate, with some arguing that pressures between 200 to 250mmH2O are equivocal (15). Alternative Names Idiopathic intracranial hypertension; Benign intracranial hypertension Causes 3Transitory symptom, normal visual acuity test. This fluid is produced in the brain and eventually is absorbed into the bloodstream at a rate that usually allows the pressure in your brain to remain constant. Idiopathic intracranial hypertension with and without papilloedema in a consecutive series of patients with chronic migraine, Diagnosis and management of benign intracranial hypertension. official website and that any information you provide is encrypted Mayo Foundation for Medical Education and Research; 2019. The https:// ensures that you are connecting to the First, your doctor will ask about your symptoms and medical history. Have a notebook and pen readyto write down things you want to remember or answers to your questions. Opening pressure >200mmH2O was present in 11 patients and, in six of these, >250mmH2O. Indian J Otolaryngol Head Neck Surg. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (, COVID-19, SARS-CoV-2, intracranial hypertension, pseudotumor cerebri, headache, Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. Follow-up is important since it is possible for symptoms to recur after treatment. ", Brigham and Women's Hospital: "Pseudotumor Cerebri (Idiopathic Intracranial Hypertension). Before The University of Connecticut Foundation, Inc. Office of Development and Alumni Relations 10 Talcott Notch RoadSuite 100 Farmington, CT 06032, Phone: 860-679-1122 Website:giving.uchc.edu. (IIH) (pseudotumor cerebri) Posted on October 21, 2021 November 28, 2022 by Ivan Wolansky. Friedman DI, Liu GT, Digre KB. Always consult an experienced specialist for a diagnosis. A cerebrospinal fluid puncture was performed, showing increased pressure (40 cm H2O). For more information about making a gift to support Bioscience Connecticut and UConn Health, please contact Abbie OBrien, director of development, at 860-679-4524 oraobrien@foundation.uconn.edu. Pseudotumor cerebri can happen if pressure rises around your brain due to too much cerebrospinal fluid. Idiopathic intracranial hypertension without papilledema: A case-control study in a headache center, Isolated unilateral abducens palsy in idiopathic intracranial hypertension without papilledema, Idiopathic intracranial hypertension without papilledema. Pseudotumor cerebri symptoms may resemble those of many other medical problems. HHS Vulnerability Disclosure, Help MRI scans may be normal or may show small ventricles or a flattened pituitary gland, both of which indicate building pressure in the skull. Isolated intracranial hypertension associated with COVID-19. In these places, patients are still getting treatment in trials and new patients can join trials. Accessibility HHS Vulnerability Disclosure, Help FOIA Check with your care team and health insurance provider to see if this is available to you, appropriate for you, and covered within your plan. COVID-19 and benign intracranial hypertension: A case report Rev Soc Bras Med Trop. https://www.ninds.nih.gov/disorders/all-disorders/pseudotumor-cerebri-information-page. Avoid light in the background that may make it difficult to see you. In all cases, SARS-CoV-2 RNA was detected by RT-qPCR through nasal and oropharyngeal swabs (Biomanguinhos kit (E+P1), FIOCRUZ, Brazil). Staff skilled in dozens of specialties work All patients were submitted to brain MRI and only in one patient were abnormalities typically seen in intracranial hypertension detected (see Table 1). Idiopathic intracranial hypertension in childhood: Pitfalls in diagnosis, Intracranial hypertension and HIV associated meningoradiculitis. The prevalence of idiopathic intracranial hypertension is characteristically higher among women, at a rate of 3.3 per 100,000 per year in females aged 1544 years, corresponding to a female: male ratio of 8:1 (13). Pseudotumor cerebri symptoms include headache and blurred vision, which can increase over time. Headache is a frequent complaint in COVID-19 patients. A core value of NBTS isPatients First.As such, we are committed to providing helpful, accurate, timely, and reliable content to our community regarding coronavirus (COVID-19). We will continue to provide to our community facts you can count on as we navigate the road ahead together. Neurology. The situation with COVID-19 is fluid and information is, at times, overwhelming. The role of hormones is not understood. If you live with someone who has a weakened immune system or is at increased risk for severe disease, you might choose to wear a mask in all indoor public settings regardless of the level of transmission in your area. Many brain tumor patients, especially malignant brain tumor patients, are considered high risk. You will need a smartphone, tablet, or computer with video, audio, a microphone, and a reliable Wi-Fi connection. The NCICancer Clinical Trials during COVID-19: Information for People with Cancerresource page will answer questions about conducting clinical trials during the pandemic and what to do if you are interested in enrolling or are currently enrolled. Find a quiet placewith minimal background noise and as few distractions as possible. Also limit salt and fluids in your diet to lower the amount of spinal fluid your body makes. Unauthorized use of these marks is strictly prohibited. However, the protective additional measures such as face shield and close contact with patients during the exam impose additional difficulties to physicians evaluating COVID-19 patients with headache. One of the best ways to ease symptoms is to lose extra pounds. They should continue to take all precautions recommended for unvaccinated people, including wearing a well-fitted mask until advised otherwise by their health care provider. People who have a condition or are taking medications that weaken their immune system may NOT be fully protected even if they are fully vaccinated. Getting treated quickly can help save your sight. For more information on COVID-19 and behavioral health, visit: 55 Chapel Street, Suite 006, Newton, MA 02458, Collaborative Ependymoma Research Network (CERN), Centers for Disease Control and Prevention (CDC), view the NCCN COVID-19 vaccination guide for people with cancer, issued guidance regarding COVID-19 vaccines for moderately or severely immunocompromised people, tips and suggestions for preparing for a virtual appointment, Outline what you would like to talk about. Pseudotumor cerebri (PTC), also known as idiopathic intracranial hypertension, is a problem caused by elevated cerebrospinal fluid pressure in the brain. Although experts don't know why this condition develops, here are other conditions that are commonly seen in people with the disorder: Female sex: Women are nine times more likely to have pseudotumor cerebri than men. Careers, Unable to load your collection due to an error. All patients had normal CSF analysis and RT-qPCR for SARS-CoV-2 was negative in all samples. Moreover, these clinical series do not describe cerebrospinal fluid (CSF) characteristics in these patients. Sleep apnea: Sleep apneais an increasingly common sleep disorder that is associated with pseudotumor cerebri. Only two of our patients had a documented papilledema. -, Guan W-J, Ni Z-Y, Hu Y, et al. Symptoms, which closely mimic those of large brain tumors, include: Obesity, other treatable . Column collections. COVID-19 is a novel form of a large family of viruses called coronaviruses. Authors contribution: In this cross-sectional study, we selected COVID-19 patients who underwent lumbar puncture due to neurological complaints from April to May 2020. If your health care facility is not allowing a caregiver or family member to accompany you to your appointment, check with your health care team to see if they can join you by speakerphone or video. CSF opening pressures higher than 250 mmH2O were considered elevated, and from 200 to 250 mmH2O equivocal. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. -, Headache Classification Committee of the International Headache Society (IHS). CSF opening pressures higher than 250mmH2O were considered elevated, and from 200 to 250mmH2O equivocal. The International Classification of Headache Disorders, 3rd edition. Individuals over the age of 60 and those with chronic conditions and/or compromised immune systems are likely at higher risk for contracting the virus as well as experiencing a more severe illness after infection. Doctors may also use the term benign intracranial hypertension. COVID-19; SARS-CoV-2; headache; intracranial hypertension; pseudotumor cerebri. The National Comprehensive Cancer Network (NCCN)* COVID-19 Vaccination Advisory Committee recommends COVID-19 vaccination for all patients with cancer, with a preference for mRNA-based vaccines. Pseudotumor cerebri signs and symptoms might include: Sometimes, symptoms that have resolved can recur months or years later. 2023 Feb 1;18:26331055231151926. doi: 10.1177/26331055231151926. You can learn more about the levels of protection different masks provide by viewing their resource:What Mask Should I Wear? Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. The .gov means its official. The https:// ensures that you are connecting to the Epub 2009 May 27. Would you like email updates of new search results? Caregivers, family, and close contacts should wear masks, maintain social distance, wash your hands, avoiding crowds, minimize travel, and taking any other preventive measures. Further pathological studies are necessary to confirm this hypothesis. After vaccination, your muscle cells begin making the S protein pieces and displaying them on . 8600 Rockville Pike Headache can be attributed to isolated intracranial hypertension in the absence of meningitic or encephalitic features in a significant number of COVID-19 patients. The studies may also show narrowed draining veins or indirect signs of abnormally elevated spinal fluid pressure. She and her family turned to the experts at Johns Hopkins who worked as a team to implant a stent, a new approach to treating this condition that is typically treated with a shunt. Common headaches such as migraineor tension headachescan coexist with pseudotumor cerebri, which can complicate the diagnosis. Declaration of conflicting interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. In both eyes, oedema of the optic disc with high elevation is observed. Your brain and spinal cord are surrounded by cerebrospinal fluid, which cushions these vital tissues from injury. You might get one or more of these tests: You'll also need regular vision tests. Plug in your deviceso you do not lose power during your appointment. Chest computed tomography showed round ground-glass opacities in both lungs (Figure 1D). . However, no detailed information on headache characteristics is presented in these reports. Available at: Silva MT, Lima MA, Torezani G, Soares CN, Dantas C, Brando CO, Espndola O, Siqueira MM, Araujo AQ. Progressively intense, daily, non-throbbing, occipital slowly spreading to the whole skull; dizziness and nausea, Refractory, intense, daily for 50 days. We reviewed clinical, imaging, and laboratory data of patients with refractory headache in the absence of other encephalitic or meningitic features. The optic, MeSH HHS Vulnerability Disclosure, Help 2 kg/m2) presented to our hospital (Children's Hospital of Philadelphia, Philadelphia, PA, USA) with 5 days of fever, headache, rash, diarrhoea, and dyspnoea. Epub 2020 Jul 8. Headache is a frequent complaint in COVID-19 patients. Because this condition causes symptoms of elevated pressure in the head which is also seen with large brain tumors but have normal scans, the condition has been called pseudotumor cerebri, meaning false brain tumor. Conclusions: As a library, NLM provides access to scientific literature. The authors report no conflicts of interest. Pseudotumor cerebri can also cause a ringing in the ears called pulsatile tinnitus, characterized by a rhythmic rushing sound in the ears that matches the persons heartbeat. Ophthalmologic evaluation is advised to confirm the presence of papilledema and to evaluate those patients with questionable or subtle papilledema (23). Vision problems in pseudotumor cerebri evolve slowly over time, with temporary episodes of visual blurring that can start in the peripheral field of vision.

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