Idiopathic intracranial hypertension
Headaches with bilateral papilledema
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The MRI sequences demonstrate:
- vertical tortuosity of the optic nerves well-visualized on sagittal-oblique sequences
- enlargement of the subarachnoid space around the optic nerves
- flattening of the posterior sclera bilaterally
- mild protrusion of the optic nerve heads well-visualized on axial T2 fat saturation
- prominent Meckel cave
- the cerebral venous sinuses are patent on postcontrast sequences with stenosis in the distal portion of both transverse sinuses on MRV images
- no mass lesion is seen at the infra- or supratentorial level.
In the absence of a cause for intracranial hypertension, the imaging features should suggest an idiopathic origin.