2023 American Academy of Neurology Abstract Website

Objective:

Co-relation of opening pressure in IIH to venous sinus changes

Background:

In Idiopathic intracranial hypertension, Flattening of globe, fluid in optic nerve sheath, empty sella all suggest elevated pressure on MRI. Flattening of venous sinus at transverse/sigmoid sinus junction on MRV has been debated as a cause vs consequence of IIH.

Design/Methods:

This retrospective study included patients >18 years of age with a diagnosis of IIH seen in the University of Kentucky between April 4th, 2020, to November 20th, 2020. Data was collected from their first visit and included their MRI and MRV.

Results:

Among 51 patients in our study, 96.1% were female, mean age at presentation was 30 years. Average BMI was 37.6(32.3-45.7) and the average opening pressure 34.2mm H2O. On MRI, 38.8%(19/51) had none of classic described MRI findings of IIH. The most frequently noted positive finding was empty sella (32.7%), followed by fluid in optic nerve sheath (28.6%). There were no significant differences in opening pressure between those with or without any of the features including empty sella, fluid in sheath or flattening of globe. The presence of multiple features and the presence of no features showed no significant differences.

For the MRV findings, individuals were classified based on severity levels. There were none with venous sinus thrombosis. MRV was normal in 10(21.3%), Mild stenosis in 2(4.3%), Moderate in 18 (38.3%) and severe at 17(36.2%). A Spearman correlation to assess the relationship between CSF opening pressure and severity of venous sinus narrowing was not significant (r = .139, p = .370).

Conclusions:

In our study we did not find statistically significant correlation between CSF opening pressure and severity of venous sinus stenosis, no statistical significance between the opening pressure of CSF and any of the findings noted on MRI including fluid in the sheath, flattening of the globe and empty sella.