Pictorial Essay

Usefulness of findings in optic nerve / eye socket / sella turcica in head MRI for diagnosis of idiopathic intracranial hypertension in a girl patient

Motohiro Taki, Yoshifusa Abe, Naoko Kinugawa, Hiroyuki Sato
Takehiko Gokan 1）, Kunio Odagiri 2）, Kazuo Itabashi
Department of Pediatrics, Radiology 1）, Showa University School of Medicine
Yokohama Aobadai Clinic

Abstract

　　We here report specific magnetic resonance imaging（MRI）findings of a female patient with idiopathic intracranial hypertension（IIH）. The patient’s chief complaints were eye position abnormality and vomiting. She had papilloedema and high cerebrospinal fluid pressure（54�p H2O）. We considered that there might be a lesion in the caput and performed a cephalic imaging study, but found no findings to suggest an intracerebral space-occupying lesion or ventricular enlargement by computed tomography（CT）. However, MRI demonstrated an empty sella. Regarding the optic nerves, there were three findings, as follows : distension of the perioptic subarachnoid space, vertical tortuosity and elongation of the orbital optic nerve, and flattening of the posterior sclera. By this MRI, we diagnosed the patient as having IIH. Currently, no MRI findings are included in the criteria for IIH diagnosis. However, evaluation of the pituitary gland and optic nerves by MRI, as well as fundoscopy, is considered to be clinically important for the diagnosis of IIH, particularly in patients without headache.

Keywords：Idiopathic intracranial hypertension, Papilloedema, Empty sella, MRI