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Abstract
The idiopathic intracranial hypertension (IIH) is a neurological disorder that is characterized by an increased intracranial pressure in the absence of a tumor or other diseases. The main symptoms are headache, nausea and vomiting as well as pulsatile tinnitus (buzzing in the ears), double vision and visual symptoms. If untreated, it may lead to vision loss due to associated swelling of the optic disc in the eye. IIH is diagnosed with a brain scan (to rule out other causes) and a lumbar puncture; lumbar puncture may also provide temporary and sometimes permanent relief from the symptoms. The condition may occur in all age groups, but is most common in young women, especially those suffering from obesity.
On average, IIH occurs in about 1 per 100,000 people, and can occur in children and adults. The median age at diagnosis is 30. IIH occurs predominantly in women, especially in the ages 20–45, who are four to eight times more likely than men to be affected. Overweight and obesity strongly predispose a person to IIH.
In the current study, the aim of the work was directed to evaluate the accuracy of MRI features in establishing or excluding the diagnosis of idiopathic intracranial hypertension (IIH) & their correlation with clinical manifestation, degree of papilledema and increased intracranial pressure.
The study was carried out on twenty-seven patients proved to have idiopathic intracranial hypertension (IIH) presenting with headache and blurred vision.
All the studied patients were subjected to full history taking, complaint and present history, thorough clinical examination, laboratory workup, visual assessment, lumbar puncture and magnetic Resonance Imaging of the brain.
We performed axial T1WI sequence, axial T2WI sequence, axial flair sequence, sagittal T1WI sequence, coronal T2WI sequence and MRV for 15 patients.
The results showed that:
The youngest patient in the study was 15 years old and the oldest was 60 years old. Sixteen patients (59%) were in the age group of 26-35 years. The mean Age of patients is 30.4. Twenty four patients (89%) were females. Seventeen patients (63%) were obese females. All patients (100%) were suffering from headache and blurred vision. All patients had papilledema on fundus examination. Eighteen of them (67%) were suffering from grade II. Four of them (15%) without optic nerve hyDROPs and fourteen patients (52%) with optic nerve hyDROPs. Lumbar puncture was done to all patients to measure the opening pressure which was between 25-55 cmH2O. Fifteen of them (56%) were measured between 25-35cm H2O. Twenty three patients were suffering from partial empty of sella turcica between grades II-III. Ten of them (37%) were suffering from grade II and had opening pressure between 25-45cmH2O, ten patients (37%) were grade III and had opening pressure between 25-45cmH2O, three patients (11%) were suffering from grade IV and had opening pressure between 25-55cmH2O. Four patients were normal (grade I- 15%) and had opening pressure between 25-45cmH2O. Seventeen patients (