Idiopathic intracranial hypertension

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Headaches with bilateral papilledema

Patient Data

Age: 30 years
Gender: Female

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.

 

Case Discussion

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

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