Menstrual Edema with Intracranial Hypertension (Pseudotumor Cerebri)

Abstract

Within the past few years considerable interest has arisen in the occurrence of edema associated with the menstrual period. Such edema varies from a complaint of “puffiness” which may arouse mild passing interest of the clinician, to gross visible edema of as much as 14 pounds, perhaps, associated with severe papilledema and markedly increased cerebrospinal fluid pressure.

In 1928 Eufinger and Spiegler¹ observed some gain in weight at the menstrual time in 47 per cent of their subjects. Okey and Stewart² found 1 to 3 pounds increase in weight at the menstrual time in 5 of 20 women subjects, and Sweeney³ reported a gain of 3 pounds or more in weight, usually premenstrually, in a third of 42 healthy young women studied. In 1933 Thomas⁴ reported 2 cases of massive menstrual edema. In his first case there was a gain of as much as 12 pounds in weight, associated with headache, blurred vision and vomiting, and a previous history of arterial hypertension and albuminuria during pregnancy. In his second case no significant antecedent illness was noted and kidney function tests were normal. The menstrual periods were associated with an increase of as much as 14 pounds in weight, severe headache, “marked choking of the discs” and “markedly increased” spinal fluid pressure. In the case reported by Atkinson and Ivy⁵ in 1936, there was marked edema of the feet and legs associated with the menstrual periods. In their case there was no evidence of abnormal serum protein levels nor of impaired. . .