Posted tagged ‘cerebrospinal fluid’

Pseudotumor Cerebri

August 13, 2010

Pseudo – What?!!  Yes, this is a true medical condition.  Why do I want to talk about this?  I want to showcase to the world how they think.  Who is they?  Those of you who actually are diagnosed with this condition, already know who they are…the standard medical community.  Basically, these patients have a range of head symptoms mostly headaches; MRI is negative; when they do a lumbar puncture to look for protein, infections, etc., they find that the opening pressure is higher than normal.

In the closed tissue space of the cranium, there is just enough room from brain, blood supply going in and out and cerebrospinal fluid which cushions the brain.  Anything extra will increase pressure so that when you stick a needle in the lower back to collect CSF, it pops the meter higher.  So, if an MRI has not been done, we get concerned about a tumor.  If there is no tumor, then why is the opening pressure so high?  Hence, the name, pseudotumor.

A specialist from a “Big Name” hospital in Los Angeles, asked me what I thought.  He had a patient that he diagnosed with this condition.  He is a little poindexter in his ivory tower all these years, looks kinda like an older Ric Moranis, no offense to Mr. Moranis.  At first, I was gullible enough to believe that he was curious and really wanted to know what we would do.  Now I realize that he asked so that he could quietly, smugly, mock my distorted thinking.  I will leave it up to you, the public to decide who is more distorted.

If the opening pressure for CSF is high and if there isn’t a tumor pushing that fluid out the needle, then there must be something.  What?  Well, our Poindexter, they, of the ivory tower stop the thought process right there and label it “idiopathic” meaning cause unknown  (some meds can cause this, but not lots, not common).  Unknown cause.  Therefore unknown treatment.  Now, get this.  This increased CSF pressure causes headache.  So, the little guy wants to have his patient come to him once a month so he can stick a needle in her back and take out CSF.  Band-Aid.

Here is my rationale…If CSF pressure is high, maybe there is too much CSF.  Why would there be too much CSF?  You are either overproducing or under resorbing. In the osteopathic philosophy, mechanical strain acquired from trauma or residual birth process could affect circulation, drainage (of blood, lymph, CSF) and resorption.  MDs think that the cranium is static.  We, traditional DOs, believe that it is dynamic, that there is a mechanism for motion and drainage.  It is the natural state.  When there is trauma or strain, the cranium does, sputter and stagnate – then what happens?  Pressure builds up -Tah Dah! Crank that mechanism up, reduce and resolve the strains and bingo the system stirs and fluids drain and pressure decreases.

Our little poindexter decides that it is impractical, not to mention that the parents might not like it.  What does he do?  Nothing.  So the patient is left on her own to suffer.  That is how they think!  They know it all.  So if they can’t do anything, no one else has the answer either.  Scary.  I feel sorry for all you patients out there diagnosed with Pseudotumor Cerebri.  Everybody else ?  Be scared.  Be wary.