Clinicoradiological profile of idiopathic intracranial hypertension

Abstract

Idiopathic intracranial hypertension (IIH) is a condition of raised intracranial pressure (ICP) in the absence of a space-occupying lesion. IIH patients usually present with typical symptoms and signs of increased ICP, such as headache, vomiting, neck pain, double vision, transient visual obscuration (TVO), and papilledema. Typical magnetic resonance imaging (MRI) findings include empty sella turcica, optic nerve tortuosity, globe flattening, and transverse sinus stenosis. All patients from July 2021 to June 2022 presented to the super-specialty neuroclinic with symptoms suggestive of IIH were included in this study after consent. Clinical patterns and MRI brain findings along with other risk factors and comorbidities were studied. Total 12 patients were studied out of which all were female. The most common age group was 31–40 years (41.6%). The most common clinical presentations were headache and TVOs followed by painless loss of vision, visual field changes and double vision. In this study, 7 out of 12 cases presented with headache (58.3%) out of which only 3 were migrainous. TVOs were presenting complaints of 7 patients (58.3%). Painless visual loss was there in 3 patients (25%), out of which only one case was bilateral (33%). In all cases (100%), MRI was suggestive of IIH. Transverse sinus stenosis in 3 cases (25%) and scleral flattening in 1 case (14.2%) were seen, respectively. Clinical suspicion followed by MRI brain is of utmost importance. Prompt diagnosis and treatment are essential in IIH patients to prevent permanent visual loss.