Magnetic resonance imaging findings in idiopathic intracranial hypertension

Background and Purpose: Idiopathic intracranial hypertension (IIH) can alter the configuration of anatomic structures of the brain and can be associated with abnormal MRI findings. We aimed to assess the MRI signs suggesting elevated intracranial pressure (ICP) that are found in patients with IIH. 
Materials and Methods: 46 Patients with IIH were investigated with Magnetic Resonance Imaging (MRI) and Magnetic Resonance venography (MRV) studies which were evaluated by two neuroradiologist to assess the presence or absence of transverse sinus stenosis (TSS), posterior globe flattening, optic nerve sheath dilation/tortuosity, and the size/appearance of the sellaturcica. 
Results: 42 patients with mean age 26 years were included, of them (66.6%) had TSS, partial empty sella was found in (69%), Pituitary displacement in (33.3%), tortuous optic nerve (61.9%), flat posterior sclera were found in (59.5%), Optic nerve sheath distension in (52.4%), and Optic nerve protrusion in (26.2%) of cases. Conclusions: The presence of the previous MRI abnormalities helps to increase the diagnostic certainty of IIH. In atypical clinical situations (in absence of papilloedema or normal CSF opening pressure), the presence of any combination of these findings may necessitate further clinical evaluation.