scholarly journals Empty Sella and Unilateral Sixth Nerve Palsy in a Pediatric Patient with Idiopathic Intracranial Hypertension

2021 ◽  
Vol 20 (4) ◽  
pp. 169-176
Author(s):  
Shin Hyeong Park ◽  
Woo Hyuk Lee ◽  
Tae Seen Kang ◽  
Hyun Kyung Cho ◽  
Yong Seop Han ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Nerve Palsy ◽  
Fluid Pressure ◽  
Brain Magnetic Resonance Imaging ◽  
Empty Sella ◽  
Resonance Imaging ◽  
The Right

Purpose: We report the case of a child with idiopathic intracranial hypertension who presented with binocular papillary edema and monocular sixth cranial nerve palsy accompanied by empty sella syndrome evident on brain magnetic resonance imaging.Case summary: A 9-year-old, normal-weight male patient visited the emergency room complaining of headache and diplopia 4 days in duration. The alternative prism cover test revealed esotropia of 16 prism diopters and a -1 right lateral gaze limitation. A fundus examination revealed papilledema and peripapillary hemorrhages in both eyes, and a visual field examination an enlarged, physiological blind spot in the right eye. Brain magnetic resonance imaging revealed elevated cerebrospinal fluid pressure, an empty sella, and posterior scleral flattening. We diagnosed and treated idiopathic intracranial hypertension. After 4 months, the papilledema and peripapillary hemorrhages of both eyes resolved, and the right lateral gaze limitation improved. The empty sella improved on brain magnetic resonance imaging, and we noted no recurrence 8 months after treatment.Conclusions: If a child with suspected idiopathic intracranial hypertension visits a hospital, but it is difficult to perform a lumbar puncture, brain magnetic resonance imaging should be scheduled. If abnormalities are found, these help to determine the course of disease.

Magnetic Resonance Imaging Changes in Idiopathic Intracranial Hypertension in Children

2009 ◽  
Vol 25 (3) ◽  
pp. 294-299 ◽  
Author(s):  
Ming Jin Lim ◽  
Kuberan Pushparajah ◽  
Wajanat Jan ◽  
David Calver ◽  
Jean-Pierre Lin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Resonance Imaging ◽  
Hypertension In Children

Posterior fossa volume in idiopathic intracranial hypertension: a magnetic resonance imaging–based study

2021 ◽  
pp. 028418512110665
Author(s):  
Emily N Milarachi ◽  
Saikrishna C Gourishetti ◽  
Jonathan Ciriello ◽  
David J Eisenman ◽  
Prashant Raghavan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intracranial Hypertension ◽  
Posterior Fossa ◽  
Idiopathic Intracranial Hypertension ◽  
Multivariate Logistic Regression Analysis ◽  
Intracranial Volume ◽  
Resonance Imaging ◽  
Cephalometric Measurements ◽  
Volumetric Measurements

Background The etiology of idiopathic intracranial hypertension (IIH) is uncertain. Studies suggest the fundamental cause of the Chiari 1 malformation, a congenitally hypoplastic posterior fossa, may explain the genesis of IIH in some patients. Purpose To assess the hypothesis that linear and volumetric measurements of the posterior fossa (PF) can be used as predictors of IIH. Material and Methods A retrospective analysis of magnetic resonance imaging (MRI) studies on 27 patients with IIH and 14 matched controls was performed. A volumetric sagittal magnetization prepared rapid acquisition gradient echo sequence was used to derive 10 linear cephalometric measurements. Total intracranial and bony posterior fossa volumes (PFVs) were derived by manual segmentation. The ratio of PFV to total intracranial volume was calculated. Results In total, 41 participants were included, all women. Participants with IIH had higher median body mass index (BMI). No significant differences in linear cephalometric measurements, total intracranial volumes, and PFVs between the groups were identified. Linear measurements were not predictive of volumetric measurements. However, on multivariate logistic regression analysis, the likelihood of IIH decreased significantly per unit increase in relative PFV (odds ratio [OR]=3.66 × 10−50; 95% confidence interval [CI]=1.39 × 10−108 to 1.22 × 10−5; P = 0.04). Conversely, the likelihood of IIH increased per unit BMI increase (OR=1.19; 95% CI=1.04–1.47; P = 0.02). Conclusion MRI-based volumetric measurements imply that PF alterations may be partly responsible for the development of IIH and Chiari 1 malformations. Symptoms of IIH may arise due to an interplay between these and metabolic, hormonal, or other factors.

Idiopathic intracranial hypertension – a wider spectrum than headaches and blurred vision

2021 ◽  
pp. 197140092110344
Author(s):  
H Urbach ◽  
IE Duman ◽  
DM Altenmüller ◽  
C Fung ◽  
N Lützen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Temporal Lobe Epilepsy ◽  
Intracranial Hypertension ◽  
Temporal Lobe ◽  
Intracranial Hypotension ◽  
Idiopathic Intracranial Hypertension ◽  
Spontaneous Intracranial Hypotension ◽  
Resonance Imaging ◽  
Imaging Signs

Background The purpose of this study was to analyse less known clinical scenarios associated with idiopathic intracranial hypertension. Methods The study involved analysis of magnetic resonance imaging signs of idiopathic intracranial hypertension in patients with spontaneous rhinoliquorrhoea ( n = 7), in patients with temporal lobe epilepsy and surgically treated antero-inferior temporal lobe meningo-encephaloceles (n = 15), and in patients who developed clinical signs of idiopathic intracranial hypertension following the treatment of spontaneous intracranial hypotension ( n = 7). Results Three of six patients with spontaneous rhinoliquorrhoea and six of 15 operated patients with temporal lobe epilepsy due to temporal lobe meningo-encephaloceles showed magnetic resonance imaging signs of idiopathic intracranial hypertension and had a body mass index >30 kg/m2. Rebound high pressure headaches and sings of idiopathic intracranial hypertension occurred in seven of 44 surgically treated spontaneous intracranial hypotension patients. Conclusions Magnetic resonance imaging findings should guide the clinician to consider (idiopathic) intracranial hypertension when patients develop spontaneous rhinoliquorrhoea, temporal lobe epilepsy secondary to temporal lobe meningoencephaloceles or high pressure headaches in spontaneous intracranial hypotension. Whether idiopathic intracranial hypertension must be regarded as a differential diagnosis or as a cause, or whether there are common pathophysiological pathways that lead to signs of idiopathic intracranial hypertension in this wider spectrum of disease is the focus of further study.

Magnetic Resonance Imaging of Idiopathic Intracranial Hypertension

2019 ◽  
Vol 39 (3) ◽  
pp. 324-329 ◽  
Author(s):  
Hale Z. Batur Caglayan ◽  
Murat Ucar ◽  
Murat Hasanreisoglu ◽  
Bijen Nazliel ◽  
Nil Tokgoz
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Resonance Imaging
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