PMC10353893_01
Magnetic resonance imaging findings: enlarged hypoglossal canal (a), small petrous apex meningocele (b), perioptic nerve sheath distension and flattening of the posterior ocular globe (c), and enlarged cerebrospinal fluid filled pituitary fossa ("empty sella") (d).
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The imaging showed several findings, including an enlarged hypoglossal canal (Figure 1(a)), a small meningocele in the petrous apex (Figure 1(b)), perioptic nerve sheath distension, posterior ocular globe flattening (Figure 1(c)), and a slightly enlarged pituitary fossa filled with cerebrospinal fluid ("empty sella") (Figure 1(d)).
Optical coherence tomography (a, b) and visual field test (c) findings of the right and left eyes at the initial examination before delivery (first pregnancy).
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Further eye exams revealed a slightly abnormal color vision test and normal visual field (Figure 2(c)). An optical coherence tomography (OCT) showed increased papillary thickness and regular macular profile bilaterally (Figures 2(a) and 2(b)).
Right and left papillary edema detected during the initial examination of both eyes during the first pregnancy (A); right and left papilla with no evidence of edema 2 months after delivery (B); right and left papillary edema detected during the initial examination of both eyes during the second pregnancy (C); right and left papilla 1 month after delivery (second pregnancy) (D).
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The bilateral papillary edema resolved within two months after delivery without any residual damage or drug intervention (Figure 3(B)). The patient continued to be monitored by the ophthalmology service, and during her second pregnancy, she experienced a recurrence of bilateral optic nerve edema (Figure 3(C)). A diagnosis of recurrent bilateral papillary edema related to chronic IIH by pregnancy was established, and the condition was managed similarly to the first episode resulting in full recovery after delivery (Figure 3(D)).