Idiopathic intracranial hypertension on CT

Case contributed by Dr Craig Hacking

Presentation

Papilloedema, headaches and visual disturbance

Patient Data

Age: 40-45 years
Gender: Female

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.

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

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Case information

rID: 42005
Published: 3rd Jan 2016
Last edited: 18th Aug 2017
Inclusion in quiz mode: Included

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