A bulging fontanelle in an infant is a worrying finding. The major causes would include infections, hydrocephalus, intracranial bleeding, and other space-occupying lesions. Less ominous, but also to be considered in the differential diagnosis, is pseudo-tumor cerebri, which is characterized by symptoms and signs of increased intracranial pressure without evidence of a mass lesion or hydrocephalus.1,2 We report on four infants with cystic fibrosis (CF) in whom pseudo-tumor cerebri developed shortly after the initiation of therapy.
Report of Patients. During the 3-year period, 1990 through 1993, 53 infants were assigned a diagnosis of CF at The Hospital for Sick Children, Toronto, Ontario. Four (7.7%) of these infants had evidence of increased intracranial pressure after diagnosis and are described herein. A diagnosis of CF was established in each patient on the basis of two consecutively elevated sweat chloride levels.
Patient 1. A 4-month-old female infant was referred with a history