• Written By: Michael Vaphiades, DO
    Neuro-Ophthalmology/Orbit

    The authors of this study evaluated the subtle signs of increased intracranial pressure visible on the MRIs of children with idiopathic intracranial hypertension (IIH) and determined the usefulness of neuroimaging for diagnosing the condition in children.

    They compared brain MRI scans of children with IIH and age-matched controls. IIH patients had flattening of the posterior sclera in 61 percent of cases versus 40 percent of controls, distension of the perioptic subarachnoid space in 65 percent versus 35 percent, intraocular protrusion of the prelaminar optic nerve in 17 percent versus 0 percent, tortuosity of optic nerve in 30 percent versus 5 percent and an empty sella in 26 percent versus 5 percent.

    The presence of three or more of these signs was 95 percent specific for predicting IIH. Additionally, the effect of general anesthesia on these neuroimaging features was minimized when multiple features were taken into account.

    The authors conclude that MRI features can assist in diagnosing IIH in children, provided that caution is used when interpreting imaging performed while a patient is under general anesthesia.