PMC6042010_01
Sagittal noncontrast head computed tomography shows an empty sella, a sign of increased intracranial pressure.
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A computed tomography (CT) scan of the brain was negative for masses, bleed, midline shift, and hydrocephalus but demonstrated an empty sella (Figure 1) and indentation of the posterior sclera of both globes at the optic nerve head insertion sites (Figure 2a and b), both of which are radiographic indictors of increased intracranial pressure (ICP).
Axial noncontrast head CT shows indentation of the posterior sclera of the right (a) and left (b) globes, respectively, a sign of increased intracranial pressure.
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A computed tomography (CT) scan of the brain was negative for masses, bleed, midline shift, and hydrocephalus but demonstrated an empty sella (Figure 1) and indentation of the posterior sclera of both globes at the optic nerve head insertion sites (Figure 2a and b), both of which are radiographic indictors of increased intracranial pressure (ICP).
Contrast enhanced T1-weighted axial magnetic resonance imaging of the brain shows enhancement and protrusion of the prelaminar optic nerves and right optic nerve tortuosity, signs of increased intracranial pressure.
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A follow-up magnetic resonance imaging (MRI) scan of the brain revealed enhancement and protrusion of the prelaminar optic nerves bilaterally and tortuosity of the right optic nerve (Figure 3), which are consistent with prolonged elevation of ICP.
Time of flight magnetic resonance venogram of the head shows a right transverse sinus "flow gap" and an asymmetrically narrowed caliber left transverse sinus. There is no evidence of venous sinus thrombosis.
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Magnetic resonance venogram (MRV) of the head demonstrated a right transverse sinus "flow gap," a common finding in patients with IIH, but no evidence of venous sinus thrombosis (Figure 4).