Aqueduct stenosis and intracranial hypertension

Case contributed by Prof. Stephen Stuckey

Patient Data

Age: 25 years

The lateral and third ventricles are enlarged, with a stenosis in the mid aqueduct, consistent with aqueductal stenosis. In addition the pituitary fossa is empty and there is prominence of the optic nerve sheaths with increased DWI signal at the optic nerve heads (MRI correlate of papilledema). Furthermore the cerebellar tonsils are low lying (Chiari I), without syrinx. 

Case Discussion

Presence of bilateral optic nerve head increased DWI signal is reported to be 100% specific, but insensitive, as an MRI correlate to clinical papilledema 1

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