Abstract

Background

Idiopathic intracranial hypertension is a clinical entity characterized by increased cerebrospinal fluid pressure of unknown cause. The diagnosis depends on raised intracranial pressure, and the absence of identifiable causes.

Aim

To investigate the correlation between CSF pressure value and radiological findings based on cranial MRI and MRV in patients with idiopathic intracranial hypertension.

Method

Patients with IIH who underwent brain MRI and MRV between June – 2019 to March– 2022 were evaluated. A total of 46 patients were assessed by one expert radiologist. The radiological score was based on the following findings: Partially empty Sella, Posterior displacement of the stalk, Flat posterior globe, Intra-ocular protrusion of ON, Peri-optic fat distention, Vertical tortuosity of ON, Slit-like ventricles, Tight subarachnoid space, Inferior displacement of cerebellar tonsils, Large Meckel's caves, Prominent arachnoid pits, and transverse sinus stenosis.

The radiological score was calculated by assigning one point for each finding present, with a maximum score of 12 points. The correlation between the computed radiological scores and CSF pressure was investigated.

Result

There was a significant correlation between CSF pressure and radiological scores (R = 0.32; P = 0.003, Kendall's rank correlation tau). But no significant correlation was detected between CSF pressure and each of the radiological findings (partial empty Sella [P = 0.06], Posterior displacement of stalk [P =0.1], Flat posterior globe [P = 0.1], Intra-ocular protrusion of ON [P = 0.04], Peri-optic fat distention [P = 0.6], Vertical tortuosity of ON [P = 0.4], Slit-like ventricles [P = 0.2], Tight subarachnoid space [P = 0.3], Inferior displacement of cerebellar tonsils [P = 0.7], Large Meckel's caves [P = 0.5], Prominent arachnoid pits [P = 0.2], Wilcoxon rank sum test).

Conclusion

There was a significant correlation between CSF pressure and a combination of radiological features of idiopathic intracranial hypertension.