Imaging signs in idiopathic intracranial hypertension: Are these signs seen in secondary intracranial hypertension too?

Background: The purpose of this study was to evaluate the difference in the occurrence of the various "traditional" imaging signs of intracranial hypertension (IIH) on magnetic resonance imaging (MRI) in patients with idiopathic (IIH) and secondary intracranial hypertension. Materials and...

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Main Authors: Divyata R Hingwala, Chandrasekharan Kesavadas, Bejoy Thomas, Tirur R Kapilamoorthy, P Sankara Sarma
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2013-01-01
Series:Annals of Indian Academy of Neurology
Subjects:
Online Access:http://www.annalsofian.org/article.asp?issn=0972-2327;year=2013;volume=16;issue=2;spage=229;epage=233;aulast=Hingwala
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author Divyata R Hingwala
Chandrasekharan Kesavadas
Bejoy Thomas
Tirur R Kapilamoorthy
P Sankara Sarma
author_facet Divyata R Hingwala
Chandrasekharan Kesavadas
Bejoy Thomas
Tirur R Kapilamoorthy
P Sankara Sarma
author_sort Divyata R Hingwala
collection DOAJ
description Background: The purpose of this study was to evaluate the difference in the occurrence of the various "traditional" imaging signs of intracranial hypertension (IIH) on magnetic resonance imaging (MRI) in patients with idiopathic (IIH) and secondary intracranial hypertension. Materials and Methods: In a retrospective analysis, the MRI findings of 21 patients with IIH and 60 patients with secondary intracranial hypertension (41 with tumors; 19 with intracranial venous hypertension) were evaluated for the presence or absence of various "traditional" imaging signs of IIH (perioptic nerve sheath distention, vertical buckling of optic nerve, globe flattening, optic nerve head protrusion and empty sella) using the Fisher′s exact test. Odds ratios were also calculated. Statistical Package for the Social Sciences version 17.0 was used for statistical analysis. Subgroup analysis of the IIH versus tumors and IIH versus venous hypertension were performed. Results: Optic nerve head protrusion and globe flattening were significantly associated with IIH. There was no statistically significant difference in the occurrence of rest of the findings. On subgroup analysis, globe flattening and optic nerve head protrusion occurred significantly more often in IIH than in tumors. However, there was no statistically significant difference in the occurrence of any of these findings in patients with IIH and venous hypertension. Conclusions: IIH is a diagnosis of exclusion. While secondary causes of raised intracranial pressure (ICP) have obvious clinical findings on MRI, some conditions like cerebral venous thrombosis may have subtle signs and differentiating between primary and secondary causes may be difficult. In the absence of any evident cause of raised ICP, presence of optic nerve head protrusion or globe flattening can suggest the diagnosis of IIH.
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spelling doaj.art-8cc0080bf3864c589bf836e4847841272022-12-21T17:13:31ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492013-01-0116222923310.4103/0972-2327.112476Imaging signs in idiopathic intracranial hypertension: Are these signs seen in secondary intracranial hypertension too?Divyata R HingwalaChandrasekharan KesavadasBejoy ThomasTirur R KapilamoorthyP Sankara SarmaBackground: The purpose of this study was to evaluate the difference in the occurrence of the various "traditional" imaging signs of intracranial hypertension (IIH) on magnetic resonance imaging (MRI) in patients with idiopathic (IIH) and secondary intracranial hypertension. Materials and Methods: In a retrospective analysis, the MRI findings of 21 patients with IIH and 60 patients with secondary intracranial hypertension (41 with tumors; 19 with intracranial venous hypertension) were evaluated for the presence or absence of various "traditional" imaging signs of IIH (perioptic nerve sheath distention, vertical buckling of optic nerve, globe flattening, optic nerve head protrusion and empty sella) using the Fisher′s exact test. Odds ratios were also calculated. Statistical Package for the Social Sciences version 17.0 was used for statistical analysis. Subgroup analysis of the IIH versus tumors and IIH versus venous hypertension were performed. Results: Optic nerve head protrusion and globe flattening were significantly associated with IIH. There was no statistically significant difference in the occurrence of rest of the findings. On subgroup analysis, globe flattening and optic nerve head protrusion occurred significantly more often in IIH than in tumors. However, there was no statistically significant difference in the occurrence of any of these findings in patients with IIH and venous hypertension. Conclusions: IIH is a diagnosis of exclusion. While secondary causes of raised intracranial pressure (ICP) have obvious clinical findings on MRI, some conditions like cerebral venous thrombosis may have subtle signs and differentiating between primary and secondary causes may be difficult. In the absence of any evident cause of raised ICP, presence of optic nerve head protrusion or globe flattening can suggest the diagnosis of IIH.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2013;volume=16;issue=2;spage=229;epage=233;aulast=HingwalaIntracranial hypertensionmagnetic resonance imagingsigns
spellingShingle Divyata R Hingwala
Chandrasekharan Kesavadas
Bejoy Thomas
Tirur R Kapilamoorthy
P Sankara Sarma
Imaging signs in idiopathic intracranial hypertension: Are these signs seen in secondary intracranial hypertension too?
Annals of Indian Academy of Neurology
Intracranial hypertension
magnetic resonance imaging
signs
title Imaging signs in idiopathic intracranial hypertension: Are these signs seen in secondary intracranial hypertension too?
title_full Imaging signs in idiopathic intracranial hypertension: Are these signs seen in secondary intracranial hypertension too?
title_fullStr Imaging signs in idiopathic intracranial hypertension: Are these signs seen in secondary intracranial hypertension too?
title_full_unstemmed Imaging signs in idiopathic intracranial hypertension: Are these signs seen in secondary intracranial hypertension too?
title_short Imaging signs in idiopathic intracranial hypertension: Are these signs seen in secondary intracranial hypertension too?
title_sort imaging signs in idiopathic intracranial hypertension are these signs seen in secondary intracranial hypertension too
topic Intracranial hypertension
magnetic resonance imaging
signs
url http://www.annalsofian.org/article.asp?issn=0972-2327;year=2013;volume=16;issue=2;spage=229;epage=233;aulast=Hingwala
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