Idiopathic intracranial hypertension

Case contributed by Pawel Piotrowicz
Diagnosis almost certain

Presentation

Acute onset of squint and double vision. Bilateral papilledema.

Patient Data

Age: 11 years
Gender: Male
  • papilledema, prominent subarachnoid space around the optic nerves, vertical tortuosity of the optic nerves

  • partially empty sella turcica

  • enlarged of left Meckel cave, right Meckel's cave is hypoplastic (probably inherited)

  • enlarged CSF space around the oculomotor nerve in the lateral wall of the cavernous sinus (best visible on Fiesta /cor/)

  • bilateral venous sinus stenosis: left transvers sinus is hypoplastic, segmental narrowing of right transvers sinus, lumen <1mm

  • no evidence of current or remote thrombosis

Case Discussion

Each of these findings isolated might not be significant although coexistence of all makes the diagnosis almost certain.

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