Pseudotumour cerebri (idiopathic intracranial hypertension)
Patient presented with pulsating headache and fluctuating visual problems. Opthalmologic examination showed papilloedema.
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You can see the typical partial empty sella turcica (e.g. 2-12 on the sagittal and 4-8 on the axial view) and the papilloedema (e.g. 4-9 on the axial view).
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Imaging of the brain with CT and MRI is essential in patients with idiopathic intracranial hypertension, to exclude elevated cerebrospinal fluid pressure due to brain tumour, dural sinus thrombosis, hydrocephalus etc...
Treatment options include CSF letting, acetazolamide and lumboperitoneal shunts. In patients with progressive visual deterioration optic nerve fenestration to preserve vision.
- Bastin ME et al. "Diffuse brain oedema in idiopathic intracranial hypertension: a quantitative megnetic resonance imaging study" J Neurol Neurosurg Psychiatry. 2003; 74:1693-6
- Bicakci K et al. "Perfusion and diffusion magnetic resonance imaging in idiopathic intracranial hypertension" Acta Neurol Scand. 2006;114:193-7