Endolymphatic hydrops and intracranial hypertension: a quantitative MRI analysis

Area of Science:

• Neurology
• Otolaryngology
• Radiology

Background:

• Endolymphatic hydrops (EH) involves inner ear fluid imbalance.
• Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure.
• The relationship between EH and IIH has not been extensively studied.

Purpose of the Study:

• To investigate the prevalence of MRI markers of IIH in patients with EH.
• To explore potential pathophysiological links between inner ear fluid dysregulation and intracranial pressure.

Main Methods:

• Retrospective review of 108 adult patients with MRI and hydrops sequences.
• Assessment of EH grading, nerve volumes, and IIH imaging features.
• Statistical analysis of the co-occurrence of EH and IIH features.

Main Results:

• High prevalence of vestibular (71.3%) and cochlear (42.6%) EH.
• Common IIH imaging markers: Meckel's cave dilatation (60.2%), empty sella (50.9%), optic nerve sheath dilation (57.4%).
• Significant associations found between EH severity and optic nerve sheath dilation, tortuosity, slit-like ventricles, and increased subcutaneous fat.

Conclusions:

• MRI reveals frequent co-occurrence of EH and IIH radiological biomarkers.
• This suggests a potential pathophysiological link between inner ear fluid dysregulation and elevated intracranial pressure.
• Prospective studies are needed to integrate clinical outcomes with advanced MRI assessments.