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Author Notes:

Please address correspondence to: Amit M. Saindane, M.D., Director, Division of Neuroradiology, Emory University Hospital, Department of Radiology, BG22, 1364 Clifton Road NE, Atlanta, GA 30322, Phone: (404) 712-4519, Fax: (404) 712-1219, asainda@emory.edu.

Read More: http://www.ajronline.org/doi/abs/10.2214/AJR.12.9638.

The findings reported in this article were presented at the 2012 annual meeting of the American Society of Neuroradiology, New York, NY.

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Research Funding:

This study was supported in part by an unrestricted departmental grant to the Department of Ophthalmology from Research to Prevent Blindness, Inc., New York, and by an NIH/NEI core grant (P30-EY06360) to the Department of Ophthalmology. B. B. Bruce receives research support from the NIH/NEI (K23-EY019341). N. J. Newman is a recipient of the Research to Prevent Blindness Lew R. Wasserman Merit Award.

Keywords:

  • CSF
  • idiopathic intracranial hypertension
  • intracranial pressure
  • MRI

Association of MRI Findings and Visual Outcome in Idiopathic Intracranial Hypertension

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Journal Title:

American Journal of Roentgenology

Volume:

Volume 201, Number 2

Publisher:

, Pages 412-418

Type of Work:

Article | Post-print: After Peer Review

Abstract:

OBJECTIVE Patients with idiopathic intracranial hypertension (IIH) have elevated intracranial pressure (ICP) without identifiable cause. The clinical course is variable, resulting in irreversible vision loss in some, and a benign course in others. While MRI findings have been described in IIH, their association with visual outcome has not been evaluated. MATERIALS AND METHODS 46 patients with IIH underwent funduscopic evaluation, visual field testing, lumbar puncture with opening pressure (OP) measurement, and MRI. Patients were stratified into: Group 1: no vision loss (n=28), Group 2: some vision loss (n=10), and Group 3: severe vision loss (n=8). MRI findings in the orbits, pituitary gland, and optic canals, and frequency of skull base cephaloceles and transverse sinus stenosis (TSS) were assessed blinded to the patients’ visual outcome. Demographic, clinical, and MRI findings were evaluated for association with visual outcome. RESULTS Patients in group 3 (worst visual outcome) were significantly younger (P=0.03) and had higher OP (P=0.04) than the other groups. There were no significant differences in gender, race, or body mass index. Despite worse visual outcomes and sometimes fulminant vision loss, there were no differences in the frequency of orbital MRI findings, TSS, or in optic canal diameter and pituitary appearance among the three groups. Group 3 had significantly lower cephalocele frequency than the other groups (P=0.04). CONCLUSION While MRI findings may suggest elevated ICP and the diagnosis of IIH, they are not predictive of visual outcome in IIH.

Copyright information:

© American Roentgen Ray Society

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