June 2014

Introduction

Idiopathic Intracranial Hypertension

Edward D. Greenberg

Edward D. Greenberg

Idiopathic intracranial hypertension (IIH), also referred to as pseudotumor cerebri, is a well known but poorly understood disease entity that presents neuroradiologists with both diagnostic and treatment challenges. The classic clinical presentation is that of an obese young woman, frequently African American, with headaches, nausea, vomiting, visual impairment, and possibly cranial nerve VI palsy. The pathophysiology of IIH is thought to … more »

Brain

Incidence of Cerebellar Tonsillar Ectopia in Idiopathic Intracranial Hypertension: A Mimic of the Chiari I Malformation

Ashley Aiken

Ashley H. Aiken

Our manuscript is the first in the radiology literature to evaluate the incidence and morphology of cerebellar tonsillar ectopia (CTE) in patients with a clinical diagnosis of idiopathic intracranial hypertension (IIH). We first became interested in the appearance of the cerebellar tonsils as we witnessed the clinical dilemma the surgeons faced in patients with headache, CTE, and high intracranial pressures. … more »

Interventional

Unilateral Transverse Sinus Stenting of Patients with Idiopathic Intracranial Hypertension

David Pelz

David Pelz

Idiopathic intracranial hypertension (IIH) is a syndrome caused by raised intracranial CSF pressure (ICP) without an underlying mass lesion, hydrocephalus, or cerebral edema. Patients typically present with intractable headaches (90%), papilledema (89%), visual changes (62%), and pulsatile tinnitus (48%). In North American women, it has a prevalence of 15–19/100,000. If left untreated, it can result in blindness. Since first described by … more »

Brain

MRI Evidence of Impaired CSF Homeostasis in Obesity-Associated Idiopathic Intracranial Hypertension

Our Search for Evidence of Impaired CSF Homeostasis in Obesity-Associated Idiopathic Intracranial Hypertension
Noam Alperin

Noam Alperin

The CSF system is a fascinating, elegant biomechanical environment important for a wide range of critical physiologic processes, from facilitating the cerebral circulation of the pulsatile blood flow in the confined space of the cranium to the accommodation of large hydrostatic changes that occur following a change in body posture … more »

Head & Neck

Automated Quantitation of the Posterior Scleral Flattening and Optic Nerve Protrusion by MRI in Idiopathic Intracranial Hypertension

Beyond Eyeballing the Eyeballs in Intracranial Hypertension
Noam Alperin

Noam Alperin

Deformation of the posterior sclera is a well-established imaging sign of intracranial hypertension (IH). In an excellent review article, Passi et al describe the appearance of the optic nerve (ON) and ocular regions on MRI in the presence of papilledema associated with increased intracranial pressure (ICP).1 They also remind us of the considerable variability in … more »

Pediatrics

Optic Nerve Sheath Diameter on MR Imaging: Establishment of Norms and Comparison of Pediatric Patients with Idiopathic Intracranial Hypertension with Healthy Controls

Anat Kesler

Anat Kesler

My main research area in neuro-ophthalmology is idiopathic intracranial hypertension (IIH) syndrome. In recent years, I have concentrated on advancing my research of this syndrome and have published papers in this field. IIH is a syndrome of increased intracranial pressure without an intracranial mass. When papilledema is present, neuroimaging is obtained before a lumbar puncture.

This research is unique due to the fact … more »