Polycystic Ovarian Syndrome and Pseudotumor Cerebri Syndrome in Female Adolescents

Pseudotumor cerebri syndrome (PTCS) is characterized by elevated intracranial pressure, normal cerebrospinal fluid (CSF) content, and the lack of any identifiable causative mass on imaging of the central nervous system. This syndrome is usually characterized by headache and double vision, and typically occurs in obese women during their reproductive years. The pathogenesis of PTCS is unknown, although various etiologic factors have been proposed as the likely cause, including changes in CSF dynamics due to metabolic-hormonal derangements and/or increased venous blood pressure in the brain due to transverse sinus stenosis. PTCS has been reported in association with several comorbidities, including polycystic ovarian syndrome (PCOS). The mechanism that leads to increased intracranial pressure and PTCS in females with PCOS awaits elucidation; however, PCOS is typically associated with hyperaldosteronism and the latter has been considered in recent years an important risk factor for PTCS, likely due to an aldosterone-mediated elevation of CSF pressure. Nevertheless, further studies remain to be done to elucidate fully the etiology of PTCS in female adolescents affected by PCOS.