MR Imaging of Idiopathic Intracranial Hypertension

MR images from the case of a 9-year-old male patient with IIH without papilledema.

A, Transverse T2-weighted image (4000/96/2 [TR/TE/excitations]), obtained at admission, shows small cortical veins and superior sagittal, straight, transverse and sigmoid sinuses but no intracranial mass lesion, ventricular dilation, or sinus thrombosis.

B, Sagittal fat-saturated T2-weighted image (4000/100/2) of the right optic nerve, obtained at admission, shows flattening of the posterior sclera, vertical tortuosity and elongation of the nerve, and distension of the perioptic subarachnoid space.

C, Sagittal T1-weighted image (500/9/2), obtained at admission, shows a partially empty sella.

D, Transverse T2-weighted image, obtained 4 months after admission and after three lumbar punctures and improvement of the clinical symptomatology, reveals a decrease in the subarachnoid space and normalization of the sizes of the cortical veins and superior sagittal, straight, transverse, and sigmoid sinuses.

E, Sagittal fat-saturated T2-weighted image of the right optic nerve, obtained 4 months after admission and after three lumbar punctures and improvement of the clinical symptomatology, shows a normally round orbit and a normally straight nerve.

F, Sagittal T1-weighted image, obtained 4 months after admission and after three lumbar punctures and improvement of the clinical symptomatology, shows that the previously compressed pituitary gland had reexpanded to fill the sella turcica.