title: Cognitive impairment in patients with Pseudotumor Cerebri Syndrome.
abstract: BACKGROUND
  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%).
  
  
  CONCLUSIONS
  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.
authors: Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors: Siddharth
authors: S
authors: Kharkar
authors: Robert
authors: R
authors: Hernandez
authors: Sachin
authors: S
authors: Batra
authors: Philippe
authors: P
authors: Metellus
authors: Argye
authors: A
authors: Hillis
authors: Michael A
authors: MA
authors: Williams
authors: Daniele
authors: D
authors: Rigamonti