Can Degenerative Disc Disease Cause Pseudotumor Cerebri?
No, degenerative disc disease does not cause pseudotumor cerebri (idiopathic intracranial hypertension). These are distinct pathological entities with completely different mechanisms and anatomical locations.
Why These Conditions Are Unrelated
Pseudotumor cerebri is defined by elevated intracranial pressure of unknown cause, occurring predominantly in obese women of childbearing age, with no structural brain abnormality, mass, or cerebrospinal fluid composition abnormality 1, 2.
Degenerative disc disease affects the spinal column, not intracranial pressure dynamics. The cervical or lumbar spine pathology involves intervertebral disc degeneration and does not alter cerebrospinal fluid production, absorption, or intracranial pressure 3.
Established Risk Factors for Pseudotumor Cerebri
The actual causes and associations with pseudotumor cerebri include:
Obesity is the strongest risk factor, particularly in women of childbearing age 4, 5.
Medications that can trigger or worsen IIH include tetracyclines (including doxycycline), vitamin A and retinoids (especially >25,000 IU daily for >6 years or >100,000 IU for >6 months), steroids (particularly withdrawal), growth hormone, thyroxine, and lithium 1, 3.
Female gender is a well-established risk factor 4.
Hypervitaminosis A from excessive supplementation or retinoid therapy 3.
Important Clinical Distinction
If a patient presents with both cervical radiculopathy symptoms (neck/arm pain, weakness, sensory changes) AND signs of elevated intracranial pressure (papilledema, headache), these represent two separate pathological processes that require independent evaluation 3.
In the rare case report of pseudotumor cerebri with polyradiculopathy 6, the radicular symptoms were caused by elevated CSF pressure compressing nerve roots—not by degenerative disc disease—and resolved completely after CSF shunting 6.
Diagnostic Approach When Both Conditions Coexist
Evaluate the spine separately with cervical or lumbar MRI to assess for disc herniation, stenosis, or nerve root compression if radicular symptoms are present 3.
Evaluate for pseudotumor cerebri with brain and orbital MRI looking for empty sella, posterior globe flattening, enlarged optic nerve sheaths, and optic nerve tortuosity, followed by lumbar puncture with opening pressure measurement (>250 mm H₂O confirms IIH) 1, 2.
Treat each condition independently: weight loss and acetazolamide for pseudotumor cerebri 1, 2, and appropriate management (physical therapy, epidural injections, or surgery) for symptomatic degenerative disc disease 3.