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Analysis of Neuroradiologic Findings in Idiopathic Intracranial Hypertension-A Population-Based Study

Yael N Steinberg1, Gregory J Parnes, Nilesh K Raval

  • 1Albert Einstein College of Medicine Training Program (YNS), Bronx, New York; Department of Ophthalmology (YNS), Boston University, Boston, Massachusetts; Department of Radiology (GJP), Jacobi Medical Center, Bronx, New York; Department of Radiology (GJP), Albert Einstein College of Medicine, Bronx, New York; Department of Ophthalmology and Visual Sciences (NKR), Montefiore Medical Center, Bronx, New York; Department of Ophthalmology (NR), New York Eye and Ear Infirmary of Mt Sinai, New York, New York; Department of Medicine (FMPS), Jacobi Medical Center, Bronx, New York; Department of Ophthalmology (FMPS), Indiana University School of Medicine, Indianapolis, Indiana; Department of Research Studies (AP), University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery (Ophthalmology) (JNM), Jacobi Medical Center, Bronx, New York; and Department of Ophthalmology and Visual Sciences (JNM), Albert Einstein College of Medicine, Bronx, New York.

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
|September 5, 2024
PubMed
Abstract

Insights

Idiopathic intracranial hypertension (IIH) predominantly affects young, obese females. Several MRI findings are more common in IIH patients, with transverse sinus stenosis (TVSS) being the most predictive sign for diagnosis.

Area of Science:

  • Neurology
  • Radiology
  • Ophthalmology

Background:

  • Idiopathic intracranial hypertension (IIH) is a condition linked to various magnetic resonance imaging (MRI) abnormalities.
  • Understanding these MRI features and their correlation with clinical data is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To assess the types of MRI findings in patients with IIH.
  • To investigate the clinical-radiologic correlations between MRI features, body mass index (BMI), and lumbar puncture opening pressure (LPOP).

Main Methods:

  • A retrospective chart review was conducted comparing IIH patients with a control group.
  • Brain MRI and magnetic resonance venography features were enumerated and statistically analyzed.
  • Sensitivity, specificity, positive predictive value (PPV), and likelihood ratios (LRs) were calculated for each identified MRI sign.

Main Results:

  • IIH patients were younger, predominantly female, and more obese than controls.
  • Patients with IIH exhibited a significantly higher number of MRI findings compared to controls.
  • Vertical nerve tortuosity, transverse sinus stenosis (TVSS), sheath expansion, and globe flattening were among the frequently observed MRI signs in IIH patients.
  • TVSS demonstrated the highest positive predictive value (95.45%) and positive likelihood ratio (22.51) for IIH diagnosis.

Conclusions:

  • The study confirms the predilection of IIH for young, obese females.
  • A greater number of MRI findings were observed in IIH patients, correlating positively with LPOP.
  • Transverse sinus stenosis (TVSS) emerged as the most significant and predictive MRI finding for diagnosing IIH.

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