Related Experiment Video
Updated: Mar 7, 2026
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Imaging Features of Idiopathic Intracranial Hypertension in Children
Alexander J P W Hartmann1, Bruno P Soares2, Beau B Bruce1,3,4
11 Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
Insights
Idiopathic intracranial hypertension (IIH) MRI findings are similar in children and adults, but less common in younger children. This study characterizes pediatric IIH MRI signs, aiding diagnosis in this population.
Area of Science:
- Neurology
- Radiology
- Pediatrics
Background:
- Elevated intracranial pressure and idiopathic intracranial hypertension (IIH) have distinct Magnetic Resonance Imaging (MRI) features in adults.
- These characteristic MRI findings are less understood in pediatric populations, particularly differentiating age groups.
Purpose of the Study:
- To characterize and compare MRI findings of IIH in prepubescent children, adolescents, and adults.
- To identify age-related differences in the frequency of specific IIH MRI signs.
Main Methods:
- Retrospective review of MRI scans from 50 children and 46 adults diagnosed with IIH.
- Evaluation for specific signs: optic nerve protrusion/enhancement, posterior scleral flattening, increased perioptic cerebrospinal fluid, optic nerve tortuosity, empty sella, tonsillar herniation, Meckel's cave enlargement, and transverse venous sinus stenosis (TSS).
Main Results:
- Children with IIH showed similar MRI findings to adults, but with lower frequencies in prepubescent children (<11 years).
- Significantly lower frequencies of scleral flattening (P=.02), empty sella (P=.007), and TSS (P=.04) were observed in prepubescent children compared to adolescents and adults.
- Trends for lower frequencies of increased perioptic cerebrospinal fluid (P=.08) and optic nerve tortuosity (P=.07) were also noted in younger children.
Conclusions:
- Pediatric IIH shares MRI features with adult IIH, but these signs manifest less frequently in prepubescent children.
- Age-specific interpretation of MRI findings is crucial for diagnosing IIH in children.
- Further research may elucidate the underlying reasons for these age-related differences in MRI presentation.
Abstract:
Magnetic resonance imaging (MRI) signs of elevated intracranial pressure and idiopathic intracranial hypertension have been well characterized in adults but not in children. The MRIs of 50 children with idiopathic intracranial hypertension and 46 adults with idiopathic intracranial hypertension were reviewed for optic nerve head protrusion, optic nerve head enhancement, posterior scleral flattening, increased perioptic cerebrospinal fluid, optic nerve tortuosity, empty or partially empty sella, tonsillar herniation, enlargement of Meckel's cave meningoceles, and transverse venous sinus stenosis(TSS). Compared to adolescents (11-17 years, n = 40) and adults (>17 years, n = 46), prepubescent children (<11 years, n = 10) had lower frequencies of scleral flattening (50% vs 89% and 85%, P = .02), increased perioptic cerebrospinal fluid (60% vs 84% and 89%, P = .08), optic nerve tortuosity (20% vs 46% and 59%, P = .07), empty or partially empty sella (56% vs 78% and 93%, P = .007), and TSS (67% vs 93% and 96%, P = .04). Children with idiopathic intracranial hypertension have similar MRI findings as adults, but they are less frequent in prepubescent children.
