MRI Findings in Idiopathic Intracranial Hypertension (IIH) Compared with Cerebral Venous Thrombosis (CVT) (P07.267)

Abstract

Objective: To compare MRI findings suggestive of elevated ICP in IIH patients with transverse sinus stenosis (TSS) versus CVT patients. Background Numerous publications have emphasized that IIH patients often have MRI findings suggestive of raised ICP in addition to TSS on vascular imaging. Design/Methods: Among 240 patients who underwent standardized contrast-enhanced brain MRI and contrast-enhanced MRV at our institution between 9/2009 and 9/2011, 60 with abnormal imaging findings on MRV were included: 29 patients with definite IIH, and 31 with definite CVT. Medical records were reviewed, and imaging studies were prospectively evaluated by the same neuroradiologist to assess for presence or absence of TSS, site of CVT if present, orbital findings of posterior globe flattening, optic nerve sheath dilation/tortuosity, and the size/appearance of the sella turcica. Results: 29 IIH patients (28 women, 19 African-Americans, mean-age 30.6, mean-BMI 35.2) had bilateral (28) or unilateral (1) TSS. 31 CVT patients (19 women, 13 African-Americans, mean-age 45.6, mean-BMI 28.6) had thrombosis of the sagittal (3), sigmoid (3), cavernous (1), unilateral transverse (7), or multiple (16) sinuses or cortical veins (1). 14 CVT patients presented with raised ICP, 15 had focal symptoms, 2 were asymptomatic. IIH patients had larger sella turcicas than CVT patients (p Conclusions: Although abnormal imaging findings involving the globes, optic nerves, and sella turcica are more common in IIH patients with TSS than in CVT patients, these findings are not specific for IIH and are found in patients with raised ICP from other causes such as CVT, along with other signs suggestive of raised ICP. Disclosure: Dr. Ridha has nothing to disclose. Dr. Saindane has nothing to disclose. Dr. Bruce has nothing to disclose. Dr. Riggeal has nothing to disclose. Dr. Kelly has nothing to disclose. Dr. Newman has received personal compensation for activities with Biogen Idec. Dr. Biousse has nothing to disclose.