Radiological Imaging in Idiopathic Intracranial Hypertension: A Case Series

Manoj Kumar Sharma; Kanchan Varma; Ashish Manohar; Vasudha Agarwal

doi:10.55489/njmr.150420251190

Authors

Manoj Kumar Sharma Department of Radiology, Kailash Hospital and Heart Institute, Noida, Uttar Pradesh, India
Kanchan Varma Department of Radiology, Kailash Hospital and Heart Institute, Noida, Uttar Pradesh, India
Ashish Manohar Department of Radiology, Kailash Hospital and Heart Institute, Noida, Uttar Pradesh, India
Vasudha Agarwal Department of Radiology, Kailash Hospital and Heart Institute, Noida, Uttar Pradesh, India

DOI:

https://doi.org/10.55489/njmr.150420251190

Keywords:

Idiopathic intracranial hypertension, Magnetic resonance imaging ( MRI ), MRV, empty sella, transverse sinus stenosis, pseudotumor cerebri, papilledema, Neuroimaging biomarkers

Abstract

Background: Idiopathic Intracranial Hypertension (IIH), or pseudotumor cerebri, is characterized by elevated intracranial pressure without a detectable secondary cause. The condition has an estimated incidence of 0.9 per 100,000 in the general population, rising to 19 per 100,000 among obese women of reproductive age. IIH is associated with significant morbidity, particularly vision loss, if not diagnosed and managed promptly.

Methodology: This retrospective case series analyzed five patients evaluated between May 2024 and May 2025 who met the modified Dandy criteria for IIH and underwent standardized MRI and MRV protocols. Patient selection involved the exclusion of secondary intracranial hypertension, and two radiologists independently reviewed images.

Results: All patients (100%) exhibited either partial or complete empty Sella, 80% (4/5) showed transverse sinus stenosis, 60% (3/5) had Meckel's cave enlargement; and 60% (3/5) had perioptic CSF space dilation; visual disturbances correlated with perioptic CSF distention. The study highlights the value of neuroimaging biomarkers in confirming IIH, guiding clinical management, and differentiating from secondary causes. However, the limited sample size and single-center scope restrict generalizability.

Conclusion: Early radiological identification and intervention are crucial to prevent irreversible complications, emphasizing the need for multi-disciplinary care and further research involving advanced imaging and long-term outcomes.

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