FIBRINOLYSIS IN PSEUDOTUMOR CEREBRI

Pseudotumor cerebri is a syndrome associated with diverse putative eti ological factors that include chemicals such as vitamin A, tetracyclin e and estrogens or venous circulatory disturbances like sagittal or tr ansverse sinus thrombosis. Diseases predisposing to thrombosis, such a s polycythemia vera and essential thrombocythemia, were reported to ca use sinus thrombosis and pseudotumor cerebri. This is a pilot study to investigate the possible role of hemostatic factors in the pathogenes is of pseudotumor cerebri. We studied nine patients with severe, recur rent, or refractory pseudotumor cerebri causing visual impairment and found abnormal euglobulin clot lysis time (prestress in all of them an d post stress in seven). Digital subtraction angiography was suggestiv e of recanalized sinus thrombosis in only three patients. We conclude that abnormalities in the fibrinolytic system are present in a subset of patients with severe pseudotumor cerebri, which calls for further s tudies on venous circulatory pathogenesis of pseudotumor cerebri and t he possible role of anticoagulants in such cases.