Idiopathic intracranial hypertension on CT

Case contributed by Dr Craig Hacking

Presentation

Papilloedema, headaches and visual disturbance

Patient Data

Age: 43
Gender: Female

No acute surface collection, haemorrhage or infarction. No mass effect, space occupying lesion or midline shift. Partially empty sella. The ventricles are normal for age and not particularly slit like. Grey - white matter differentiation is preserved. The optic nerves appear normal for CT. The transverse sinuses appear small. The paranasal sinuses and mastoid air cells are clear. No acute bony abnormality.

Conclusion

No obvious cause of symptoms evident. There are a few signs that are non-specific but in combination can be seen in idiopathic intracranial hypertension.

CT

CT venogram

The transverse and sigmoid sinuses are narrowed however no thrombosis is identified within them. The left side is slightly dominant. The superior sagittal sinus is normal.

No cortical vein thrombosis evident.

Conclusion

No dural venous sinus thrombosis evident. Narrowing of the transverse and sigmoid sinuses is another sign of idiopathic intracranial hypertension, and correlation with LP and opening pressures is advised.

Case Discussion

LP revealed increased opening pressure. The patient responded to acetazolamide

PlayAdd to Share

Case information

rID: 42005
Case created: 31st Dec 2015
Last edited: 3rd Jan 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.