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Bilateral papilledema by cerebral pseudotumor syndrome in a patient with a fortuitous finding of pituitary microadenoma

ABSTRACT

The present report describes a rare case of bilateral papilledema due to cerebral pseudotumor syndrome (CPT) related to an occasional finding of pituitary microadenoma. We report the case of a 21-year-old female patient presenting low far visual acuity, associated with headache beginning 2 months ago. On ophthalmological examination, fundoscopy showed significant bilateral papilledema. Magnetic resonance imaging of the brain showed symmetrical and normal-sized ventricles, besides a nodular imaging in the pituitary, measuring 7 mm, without any evidence of intracranial compression, insufficient to cause the symptoms of the clinical presentation. After the diagnosis of cerebral pseudotumor syndrome, clinical treatment with acetazolamide was instituted and weight loss was advised, with satisfactory evolution. The description of both pathologies mutually present was mentioned only once during extensive literature review. Thus, we call attention to this unusual occurrence, emphasizing the characteristics of both pathologies in order to facilitate the differential diagnosis, as well as to elucidate the best therapeutic approach. We emphasize that the finding of small pituitary adenomas should not confuse the etiological diagnosis in patients with visual complaints and bilateral papilledema.

Pseudotumor cerebri; Papilledema; Pituitary adenoma

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