Idiopathic intracranial hypertension (pseudotumor cerebri)

Case contributed by Dr Dalia Ibrahim

Presentation

Headache and papilledema.

Patient Data

Age: 10 years
Gender: Male

Both optic nerves show

  • flattening of the posterior sclera and protrusions of the optic nerve heads (This is the radiographic correlate with papilledema)
  • vertical tortuosity of the optic nerves
  • prominent subarachnoid space around the optic nerves.

MRV: revealed a hypoplastic left transverse sinus and  smooth-bordered stenoses in distal portions of both transverse sinuses (more at the left side)

 

Both optic nerves show

  • flattening of the posterior sclera (dashed lines
  • protrusions of the optic nerve heads (red arrows)
  • prominent subarachnoid space around the optic nerves (yellow arrows)
  • vertical tortuosity of the optic nerves

MRV:  bilateral smooth stenoses in distal portions of both transverse sinuses, worse on the left side (circles)

Case Discussion

Both optic nerves show

  • flattening of the posterior sclera and protrusions of the optic nerve heads (This is the radiographic correlate with papilledema)
  • vertical tortuosity of the optic nerves
  • prominent subarachnoid space around the optic nerves.

MRV usually reveals bilateral distal stenoses of both transverse sinuses.

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