Magnetic resonance imaging in pseudotumor cerebri

Area of Science:

• Neurology
• Radiology
• Ophthalmology

Background:

• Elevated intracranial pressure (ICP) can lead to serious neurological complications.
• Pseudotumor cerebri (idiopathic intracranial hypertension) is a condition characterized by increased ICP without an identifiable cause.
• Accurate and timely diagnosis of elevated ICP is crucial for effective management.

Purpose of the Study:

• To evaluate the utility of magnetic resonance (MR) imaging in predicting elevated intracranial pressure.
• To identify specific MR imaging findings associated with pseudotumor cerebri.

Main Methods:

• Retrospective case series involving 20 patients with pseudotumor cerebri and 20 controls.
• MR imaging was performed to assess six neuroimaging signs: posterior scleral flattening, optic nerve enhancement, perioptic subarachnoid space distension, optic nerve protrusion, optic nerve tortuosity, and empty sella.
• The presence and frequency of these signs were compared between patients and controls.

Main Results:

• Several MR imaging signs were significantly more prevalent in patients with pseudotumor cerebri compared to controls.
• Flattening of the posterior sclera (80%) and empty sella (70%) were the most common findings in patients.
• MR imaging signs allowed for the prediction of elevated ICP in 90% of pseudotumor cerebri cases and correctly identified absence in all controls.

Conclusions:

• A specific constellation of MR imaging findings is associated with elevated intracranial pressure.
• These MR imaging signs can serve as valuable tools in the diagnostic process for pseudotumor cerebri.
• MR imaging offers a non-invasive method to support the diagnosis of conditions causing elevated ICP.