Neuroradiology of idopathic Intracranial Hypertension
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Neuroradiology of idopathic Intracranial Hypertension

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Neuroradiology of idopathic Intracranial Hypertension

Neuroradiology of idopathic Intracranial Hypertension

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Neuroradiology of idopathic Intracranial Hypertension Neuroradiology of idopathic Intracranial Hypertension Presentation Transcript

  • Dr.Roopchand.PSSenior Resident AcademicDepartment of NeurologyTDMC, AlappuzhaNEURORADIOLOGY - IIH
  • INTRODUCTION: A disorder of unknown etiology. Affects young obese females Presents with features of raised ICT and papilledema. Otitic hydrocephalus – pre imaging era Pseudotumor ceribri – pneumatoencephalogram era Benign intracranial hypertension ? Vision Idiopathic intracranial hypertension.
  • DIAGNOSTIC CRITERIA: Modified Dandy criteria  Signs and symptoms of raised ICT  No localizing neurologic signs (exception of a unilateral or bilateral sixth nerve paresis)  CSF may show increased pressure, but no cytologic or chemical abnormalities.  Normal to small symmetric ventricles  Diagnostic lumbar puncture done with the patient in the lateral decubitus position.  MRI or MRV should be included to rule out intracranial venous sinus thrombosis.  Other causes of intracranial hypertension should be ruled out
  • PATHOPHYSIOLOGY: Collapsible Dural venous sinuses Increased arterial blood flow. Obesity: increased intra abdominal pressure.
  • ETIOLOGY: Exposure to or withdrawal of drugs. Systemic diseases Disruption of cerebral venous flow Certain endocrine or metabolic disorders
  • CRITERIA FOR INCLUDING A DRUG OR ADISEASE AS A CAUSE OF IIH: Radhakrishnan et al..  At least 2 cases should have been described  The reported cases should have met all the criteria for the diagnosis of IIH.  Intracranial dural sinus thrombosis should have been ruled out with reasonable certaintyRadhakrishnan K, Ahlskog JE, Garrity JA, Kurland LT. Idiopathic intracranialhypertension. Mayo Clin Proc. Feb 1994;69(2):169-80
  • PNEUMOENCEPHALOGRAM:
  • CT FINDINGS: Optic nerve edema due to iih Slit like ventricles
  • MRI:
  • pappilloedema, enlarged perioptic csf spaces with mild tortuosity of optic nerves,empty sella , prominent suprasellar cistern
  • Posterior scleral flattening
  • Empty sella in IIH
  • Brain MRI (1.5Tesla). (a)Sagittal T2-weightedimageshowingempty sella(white arrow);(b) axial T2-weightedimageshowingbuckling ofoptic nerveswith normalretro-orbitalstructures; (c)coronal T2-fatsaturatedimageshowingincreased CSFspacesaroundbilateral opticnerves; (d) T1post-contrastcoronal image