Benign intracranial hypertension

Case contributed by Mohamed Mahmoud Elthokapy
Diagnosis almost certain

Presentation

History of daily headaches/migraine and transient visual symptoms, fundus examination revealed papilledema.

Patient Data

Age: 35 years
Gender: Female

Secondary changes reflecting an element of idiopathic intracranial hypertension as denoted by flattening of the posterior sclera, vertical tortuosity, and elongation of the orbital optic nerves, with relative distension of the peri-optic subarachnoid space, associated with partially empty sella secondary to caudal herniation of the suprasellar cistern through a widened diaphragma sellae  as dedicated in sagittal T1-weighted images, slightly prominent bilateral basal ganglia perivascular spaces (Virchow Robin spaces)

Case Discussion

The MR findings are suggestive of benign intracranial hypertension.

This patient was advised to have CSF pressure that was measured via a lumbar puncture which revealed elevated pressures (28cm H2O). 

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