特发性颅内高压的临床放射学分析

P. Yadav
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摘要

特发性颅内高压(IIH)是一种在没有占位性病变的情况下颅内压(ICP)升高的情况。IIH患者通常表现为颅内压增高的典型症状和体征,如头痛、呕吐、颈部疼痛、重影、一过性视障(TVO)和乳头水肿。典型的磁共振成像(MRI)表现包括蝶鞍空、视神经扭曲、球体变平和横窦狭窄。2021年7月至2022年6月期间,所有在超级专科神经诊所就诊并伴有IIH症状的患者均经同意纳入本研究。研究了临床模式和MRI脑结果以及其他危险因素和合并症。12例患者均为女性。31-40岁为最常见年龄组(41.6%)。最常见的临床表现是头痛和TVOs,其次是无痛性视力丧失、视野改变和复视。在本研究中,12例患者中有7例出现头痛(58.3%),其中只有3例为偏头痛。tvo患者中有7例(58.3%)出现主诉。无痛性视力丧失3例(25%),其中双侧视力丧失1例(33%)。所有病例(100%)MRI提示IIH。横窦狭窄3例(25%),巩膜扁平1例(14.2%)。临床怀疑后的MRI脑是至关重要的。对于IIH患者,及时诊断和治疗对于防止永久性视力丧失至关重要。
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Clinicoradiological profile of idiopathic intracranial hypertension
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.
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