Supplementary Material for: A rare case of secondary pseudotumor cerebri syndrome in a female with a tongue base tumor: a case report

We report the case of a 43-year-old female of normal weight initially suspected of idiopathic intracranial hypertension (IIH), who was subsequently diagnosed with secondary pseudotumor cerebri syndrome (PTCS) caused by a tongue base tumor leading to obstructive sleep apnea (OSA). She presented with symptoms consistent with PTCS, including headache, transient visual obscurations, and progressive visual decline. Fundoscopy revealed severe bilateral papilledema, and lumbar puncture showed an opening pressure of 43 cm H2O. Despite treatment with acetazolamide, her vision worsened, and optic nerve sheath fenestration was performed. Further investigation identified OSA caused by a benign tumor of the tongue as the underlying etiology. Following continuous positive airway pressure (CPAP) therapy her headache and papilledema resolved. The case illustrates the importance of thorough search for secondary causes in patients diagnosed with PTCS.