Role of MRI in evaluation of Idiopathic Increased Intracranial Tension

Abstract

Benign intracranial hypertension (BIH) (also known as pseudo tumorcerebri and idiopathic intracranial hypertension) is a benign headache syndrome characterized by raised CSF pressure in the absence of an intracranial mass lesion or ventricular dilation, Indeed, cerebrospinal fluid (CSF) composition usually of normal contents but increased pressure (opening pressure during lumbar puncture) to exclude other overlapping pathologies, The clinical diagnostics of BIH are headache and papilledema, which may be bilateral, asymmetrical, or even unilateral (Acheson 2006). Early recognition is important as rapid intervention may preserve vision and enables the neurosurgeon to start the appropriate treatment before rapid deterioration of vision (Ball & Clarke 2006). Recent studies hypothesized that BIH pathophysiology have been based on the assumption of increased venous sinus pressure, decreased spinal fluid absorption, increased spinal fluid secretion, increased blood volume, and brain oedema (Butros et al. 2012). The cerebral ventricular system consists of a series of interconnecting spaces within the brain, which are derived from the central lumen of the embryonic neural tube and the cerebral vesicles to which it gives rise to: •Lateral ventricles Discussion 113 •Third ventricle •Aqueduct of Sylvius •Fourth ventricle The pathophysiologic mechanisms underlying the raised ICP in BIH remain unclear, but those proposed classically include increased brain water content, excess cerebrospinal fluid (CSF) production, reduced CSF absorption, and increased cerebral venous pressure. As emphasized, any pathophysiologic theory must ultimately account for the remarkable predilection BIH has for obese young women, as well as the few epidemiologic observations described above (Fraser & Plant 2011). In the field of neuroradiology, many modalities emerged in the last decades revolutionized the diagnosis principle and modulated the treatment options. Benign increased intracranial tension was not beyond that era. One should consider the belonging of BIH signs in every modality discussed below to the pathology of BIH rather than the clarity of this mean. Methodology This study included 20 patients complaining of symptoms and signs of chronic increased intracranial tension with normal CT scan . All the patient presented to Radiology Department, El-Demerdash University Hospital from January 2015 to January 2016.