Idiopathic intracranial hypertension
Chronic headache, poor vision for three years. Right sided papilledema.
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CSF filled sella and compressed pituitary gland (empty sella sign).
Bulging of prelaminar portions of bilateral optic nerves into the posterior chamber consistent with papilledema -prominent in the left side-.
The CSF space around bilateral optic nerves appear prominent with some buckling of bilateral optic nerves -prominent at right side-.
MR venography images show no sign of cerebral venous sinus thrombosis; while there is evidence of hypoplastic left transverse sinus and smooth-bordered stenosis in distal portions of both transverse sinuses.
Grey and white matter structures of brain parenchyma are returning normal signal.
No area of ischemic infarction, intracranial hemorrhage or mass lesion.
No cerebral edema, midline shift or hydrocephalus noted.
The basal ganglia are unremarkable.
Brain stem and cerebellum appear unremarkable. No cerebellar tonsillar herniation is noted.
Idiopathic intracranial hypertension is a diagnosis of exclusion hence other causes of increased intracranial pressure should be excluded like a space occupying lesion and cerebral venous sinus thrombosis.