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Can ‘SOVAC’- a set of brain magnetic resonance imaging findings- detect idiopathic intracranial hypertension?

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1 King Fahad Military Medical Complex Dhahran

2 Radiology Department, King Fahad Military Medical Complex, Saudi Arabia, Dhahran.

3 Radiology Department, King Fahad Military Medical Complex, Saudi Arabia, Dhahran.

4 Radiology Department, King Fahad Military Medical Complex, Saudi Arabia, Dhahran.

5 Radiology Department, King Fahad Military Medical Complex, Saudi Arabia, Dhahran.

6 Radiology Department, King Fahad Military Medical Complex, Saudi Arabia, Dhahran.

7 Radiology Department, King Fahad Military Medical Complex, Saudi Arabia, Dhahran.

Abstract

Objective To determine diagnostic ability of brain magnetic resonance imaging (MRI) in detection of idiopathic intracranial hypertension (IIH). Method This descriptive observational study was conducted in radiology department from Jan. 2018 to Jan. 2021, evaluating MR imaging data of all adult patients (n=107) with clinical presentations of headaches. Patients with space occupying lesions, obstructive hydrocephalus and cerebral venous sinus thrombosis were excluded. Presence of all three brain MRI findings of (i) an empty sella (with or without sellar enlargement), (ii) tortuosity of optic nerves (with or without perioptic CSF prominence) and (iii) non-dilated (or slit-like) ventricles was considered positive for IIH. Imaging was reviewed by two neuroradiologists and consensus reporting was made. Findings of IIH were confirmed by presence of high lumbar opening cerebrospinal fluid (CSF) pressure or symptomatic response towards specific medical treatment. Outcomes of brain MRIs were presented on a 2x2 contingency table. Results Sensitivity, and specificity of routine brain MRI findings in detection of IIH were calculated as 76.4% [95% confidence interval (CI), 64.62-85.91%], and 84.6% (95% CI, 69.47-94.14%) respectively.   Conclusion: IIH is a known cause of headache. Detection of all three findings of empty sella, tortuosity of optic nerves and non-dilated ventricles on routine brain MRI can predict IIH with greater sensitivity and specificity.

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Training
Radiological Education
Quality Assurance
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Keywords

Headache
Idiopathic Intracranial Hypertension
Magnetic Resonance Imaging

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