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Role of brain magnetic resonance imaging/ ‎magnetic resonance venography in the ‎diagnosis of idiopathic intracranial ‎hypertension

    Authors

    1 Iraqi board of medical specilization/ Medical collage/ Al-Nahrain ‎University.‎ Baghdad- Iraq‎

    2 Medical collage/ Al-Nahrain University.‎ Radiologist in Al-Imamian Al-Kadhimyian medical city - Baghdad- Iraq

,

Document Type : Research Paper

Abstract

Abstract
Background: Idiopathic intracranial hypertension (IIH) is an idiopathic condition. MRI ‎is essential to exclude elevated cerebrospinal fluid pressure due to other causes such ‎as brain tumour, dural sinus thrombosis, hydrocephalus, etc.‎
Aims: to determine the role of brain magnetic resonance imaging and venography in the ‎diagnosis of idiopathic intracranial hypertension and to determine the sensitivity and ‎specificity of each single radiological sign and in combination.‎
Patients and method: A prospective case control study was done in Al- Imamain Al-‎Kadhmain medical city between September 2021 and November 2022. A random ‎selection of 40 patients (3 males and 37 females) with clinical features, neurological ‎examination, brain MRI/ MRV and confirmed diagnosis of IIH. Forty controls were also ‎randomly selected. A total of 10 brains MRI/MRV signs were evaluated.‎
Results: There is significant difference of the 10 MRI signs between patient group and ‎control group. Regarding the sensitivity and specificity of each MRI sign: empty sella ‎‎(97% sensitive, 77% specific), flat sclera (82%, 95%), Perioptic nerve sheath distension ‎‎(90%, 95%), Intraocular protrusion (22%, 100%), vertical tortouisity f the optic nerve ‎‎(35%, 95%), enlarged meckel’s cave (82%, 92%), posterior displacement of the stalk ‎‎(67%, 75%), slit like ventricle (55%, 97%), meningoceles (15%, 97%) and cerebral ‎venous sinus stenosis (70%, 92%). Combination of MRI signs increases the sensitivity ‎and specificity with combination of 3 signs and above would reach 100% specificity.‎
Conclusion: Five MRI signs have the highest sensitivity and specificity (flat sclera, ‎perioptic nerve sheath distension, empty sella, large meckel’s cave, and cerebral venous ‎sinus stenosis). Combination of MRI signs especially (optic nerve tortuosity/ optic ‎nerve distension) and (flat sclera/ optic nerve distension) has significantly increased the ‎sensitivity and specificity. Presence of 3 signs or more has the highest specificity.‎

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Iraqi Postgraduate Medical Journal
Volume 24, Issue 1
January 2025
Page 130-136
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