Intracranial hypertension (pseudotumour cerebri)
Increasing headaches and visual deterioration.
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The supra- and infratentorial brain has normal signal and morphology. There is no diffusion restriction, abnormal magnetic susceptibility or abnormal post-contrast enhancement. Both transverse sinuses are focally narrowed distally. There is no evidence of an obstructing mass. No filling defect is detected within the sinuses. Fluid is noted within the optic nerve sheath bilaterally. There is also flattening of the posterior sclera bilaterally and slight anterior bulging consistent with papilloedema. The appearances of the sella are within normal limits however the pituitary appears small.
The MRI appearances support a clinical diagnosis of idiopathic intracranial hypertension. No evidence of dural venous sinus thrombosis or intracranial mass.
Typical appearances of pseudotumour cerebri (idiopathic intracranial hypertension). Elevated CSF opening pressures confirmed on lumbar puncture.