Based on a 2011 study including patients with elevated intracranial pressure, 6 signs were more prevalent in patients with IIH: partially empty sella, posterior displacement of the pituitary stalk, flattening of the posterior globe, optic nerve head protrusion, optic nerve sheath distension, and optic nerve sheath tortuosity. Three of the above signs were shown to be highly specific for IIH: partially empty sella, flattening of the posterior globe, and optic nerve head protrusion [35,41]. A small-scale study has shown the potential utility of semiautomated volumetric evaluation of the optic nerve sheath and hypophysis to help diagnose IIH [42]. MRV Head With IV Contrast Venous outflow obstruction either by an intraluminal thrombus or an extrinsic stenosis has been shown to be associated with elevated intracranial pressure and IIH; therefore, venous imaging such as brain MRV can be useful in the imaging evaluation of headache with features of intracranial hypertension. The decision to use noncontrast (eg, time-of-flight or phase-contrast) versus contrast techniques may depend on the preferences of different institutions. The use of IV contrast helps clearly delineate the venous sinus lumen and avoids some of the flow- related artifacts encountered in noncontrast MRV techniques, which can be more prone to misinterpretation [36,38]. Therefore, noncontrast brain MRV should be interpreted with attention to possible artifacts related to slow or turbulent flow and in conjunction with brain MRI, if previously performed. MRV Head Without and With IV Contrast Venous outflow obstruction either by an intraluminal thrombus or an extrinsic stenosis has been shown to be associated with elevated intracranial pressure and IIH; therefore, venous imaging such as brain MRV can be useful in the imaging evaluation of headache with features of intracranial hypertension.
Headache PCAs. Based on a 2011 study including patients with elevated intracranial pressure, 6 signs were more prevalent in patients with IIH: partially empty sella, posterior displacement of the pituitary stalk, flattening of the posterior globe, optic nerve head protrusion, optic nerve sheath distension, and optic nerve sheath tortuosity. Three of the above signs were shown to be highly specific for IIH: partially empty sella, flattening of the posterior globe, and optic nerve head protrusion [35,41]. A small-scale study has shown the potential utility of semiautomated volumetric evaluation of the optic nerve sheath and hypophysis to help diagnose IIH [42]. MRV Head With IV Contrast Venous outflow obstruction either by an intraluminal thrombus or an extrinsic stenosis has been shown to be associated with elevated intracranial pressure and IIH; therefore, venous imaging such as brain MRV can be useful in the imaging evaluation of headache with features of intracranial hypertension. The decision to use noncontrast (eg, time-of-flight or phase-contrast) versus contrast techniques may depend on the preferences of different institutions. The use of IV contrast helps clearly delineate the venous sinus lumen and avoids some of the flow- related artifacts encountered in noncontrast MRV techniques, which can be more prone to misinterpretation [36,38]. Therefore, noncontrast brain MRV should be interpreted with attention to possible artifacts related to slow or turbulent flow and in conjunction with brain MRI, if previously performed. MRV Head Without and With IV Contrast Venous outflow obstruction either by an intraluminal thrombus or an extrinsic stenosis has been shown to be associated with elevated intracranial pressure and IIH; therefore, venous imaging such as brain MRV can be useful in the imaging evaluation of headache with features of intracranial hypertension.