Computed tomography in benign intracranial hypertension.

Area of Science:

• Neurology
• Radiology
• Ophthalmology

Background:

• Benign intracranial hypertension (BIH) is a condition characterized by increased intracranial pressure without a clear cause.
• Cerebrospinal fluid (CSF) pressure dynamics are central to BIH pathophysiology.
• Neuroimaging plays a crucial role in diagnosing and monitoring BIH.

Purpose of the Study:

• To evaluate the spectrum of CT findings in patients diagnosed with benign intracranial hypertension.
• To identify imaging features that may be reversible with normalization of CSF pressure.
• To correlate CT findings with visual outcomes.

Main Methods:

• Retrospective analysis of CT scans from 28 patients with confirmed benign intracranial hypertension.
• Detailed assessment of specific intracranial structures including ventricles, cisterns, sella, and optic nerve sheaths.
• Correlation of imaging findings with clinical data, including CSF pressure measurements and visual acuity.

Main Results:

• CT demonstrated abnormalities in 36% of the studied patients.
• Observed abnormalities included small ventricles, empty sella, enlarged cisterna magna, and dilated optic nerve sheaths.
• Small ventricles and basal cisterns showed reversibility upon normalization of CSF pressure; optic nerve sheath dilation persisted in some patients, irrespective of visual acuity.

Conclusions:

• CT imaging reveals characteristic, though not universal, abnormalities in benign intracranial hypertension.
• Reversibility of ventricular and cisternal changes suggests a dynamic response to intracranial pressure fluctuations.
• Optic nerve sheath dilation on CT may represent a persistent finding in BIH, warranting further investigation regarding its long-term implications and relationship to visual function.