Idiopathic intracranial hypertension

Case contributed by Dr Hidayatullah Hamidi

Presentation

Chronic headache, poor vision for three years. Right sided papilledema.

Patient Data

Age: 30 years
Gender: Female

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. 

Case Discussion

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.

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Case information

rID: 73523
Published: 14th Jan 2020
Last edited: 14th Jan 2020
Inclusion in quiz mode: Included

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