Idiopathic intracranial hypertension

Case contributed by Derek Smith
Diagnosis almost certain

Presentation

Known IIH. New vomiting and disc blurring on optical assessment.

Patient Data

Age: 25 years
Gender: Female
This study is a stack
Axial
non-contrast
This study is a stack
Axial
venogram
This study is a stack
Sagittal
non-contrast
This study is a stack
Sagittal
venogram
This study is a stack
Sagittal
bone window
Axial
venogram
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Info

No hematoma or other mass lesion.

Normal ventricle size, with no critical herniation or tonsillar descent.

Partly empty pituitary sella / arachnoid herniation, with increased dimension from a study five years earlier. 

Distention and distortion of the optic nerve sheaths. Protrusion the optic nerve heads.

No venous sinus thrombosis. Some narrowing of the lateral transverse sinuses.

Case Discussion

This case demonstrates some features seen in idiopathic intracranial hypertension, with a particularly good example of radiological papilledema on CT.

The opening pressure on subsequent lumbar puncture was 43 cmH2O.

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