Idiopathic intracranial hypertension

Case contributed by Ammar Haouimi
Diagnosis possible

Presentation

Bilateral papilledema grade 3

Patient Data

Age: 20 years
Gender: Female
This study is a stack
Sagittal
T1
This study is a stack
Axial
FLAIR
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Coronal
T2
This study is a stack
Axial T2
fat sat
This study is a stack
Coronal T2
fat sat
This study is a stack
Axial T1
fat sat
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Coronal T1
C+ fat sat
This study is a stack
Axial
T1 C+
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Info

The MRI sequences demonstrate:

  • flattening of the posterior sclera bilaterally
  • protrusions of the optic nerve heads 
  • vertical tortuosity of the optic nerves
  • enhancement of the prelaminar (intra-ocular) optic nerves well-visualized on postcontrast axial T1 fat saturation
  • slight enlargement of the subarachnoid space around the optic nerves
  • Partially empty sella turcica (pituitary gland's height=4.5 mm)
  • the cerebral venous sinuses are patent on postcontrast sequences with no significant stenosis (MRV was not performed)
  • no mass lesion is seen at the infra- or supratentorial level.

Case Discussion

MRI findings suggestive of an idiopathic intracranial hypertension

In the absence of a cause for intracranial hypertension, the imaging features should suggest an idiopathic origin

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