Presentation
Poor vision and headache for one week. Bilateral papilledema noted on funduscopy exam.
Patient Data
Age: 16 years
Gender: Female
From the case:
Idiopathic intracranial hypertension
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Flattening of the posterior sclera and protrusions of the optic nerve heads (papilledema).
Prominent subarachnoid space around the optic nerves with evidence of vertical tortuosity of the optic nerves.
There is mild cerebellar tonsillar descent on the left side (0.8 cm).
MR venography shows narrowing of the lateral parts of both transverse sinuses. No filling defecting the cerebral venous sinuses to suggest thrombosis.
No abnormal meningeal enhancement.
No empty sella sign.
Case Discussion
The features are suggestive of idiopathic intracranial hypertension. The slight tonsilar descent is likely secondary to intracranial increased pressure.
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