Idiopathic intracranial hypertension without papilledema

Abstract

Pulsatile tinnitus and obesity suggest possible IIHWOP in patients with CDH. Treatment of patients with increased intracranial pressure was not satisfactory.

MR Imaging of Papilledema and Visual Pathways: Effects of Increased Intracranial Pressure and Pathophysiologic Mechanisms

“…27 The ophthalmoscopic appearance of IIH is most often characterized by bilateral ON head swelling, but this can be subtle and variable. [28][29][30][31][32][33] Furthermore, papilledema may be asymmetric or unilateral, 33,34 and the degree of ON head swelling is poorly correlated with ICP.…”

“…22 On the other hand, intracranial hypertension can occur without the presence of papilledema. [28][29][30][31][32]35 Possibly, MR imaging could assess the presence of intracranial hypertension before the development of papilledema. According to Hansen and Helmke, 4 there is a correlation between the width of the ONS and increased ICP.…”

Evaluation of Tinnitus in the Emergency Department

“…Pulsatile tinnitus in one series was reported to occur in 60% of patients; accompanying symptoms include headache, visual disturbances, and retrobulbar pain 20 . Indeed, the combination of headache with pulsatile tinnitus is fairly specific for the diagnosis of pseudotumor cerebri [20][21][22] . The most common signs on physical exam include papilledema, loss of visual fields, and cranial nerve VI palsy.…”

“…The most common signs on physical exam include papilledema, loss of visual fields, and cranial nerve VI palsy. Occasionally, pseudotumor cerebri has been reported in the absence of papilledema [22][23][24] . Untreated pseudotumor cerebri may lead to permanent vision loss 25 .…”

A case report of all-trans retinoic acid-induced pseudotumor cerebri in an adult patient of acute promyelocytic leukemia

“…There have been reports that have confi rmed that PTC may occur in the absence of papilloedema. 12 Visani et al reported that PTC is a complication of ATRA therapy occurring predominantly in pediatric patients typically within 2 weeks of initiation of the treatment. 11 MR imaging of the optic nerves and pituitary gland may suggest the diagnosis of raised intracranial tension (ICT) such as fl attening of the posterior sclera, swelling of the perioptic subarachnoid space, vertical tortuosity, and elongation of the optic nerve, squashed pituitary gland or empty sella.…”