Presentation
Papilledema, headaches and visual disturbance
Patient Data
No acute surface collection, hemorrhage 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.
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
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