CT Orbits There is no relevant literature to support the use of CT orbits in the initial evaluation of children with papilledema or suspected raised intracranial pressure. CTA Head There is no relevant literature to support the use of CTA head in the initial evaluation of children with papilledema or suspected raised intracranial pressure. CTV Head CT venography (CTV) of the head may be an alternative to MR venography (MRV) for the evaluation of cerebral venous sinuses [42]. MRA Head There is no relevant literature to support the use of MRA head in the initial evaluation of children with papilledema or suspected raised intracranial pressure. MRI Head and Orbits MRI of the head and orbits is the most useful imaging modality for initial evaluation of the child presenting with papilledema and signs of raised intracranial pressure by detection of intracranial space occupying lesion or hydrocephalus. MRI is more useful over CT in children because of the ability of MRI to provide a higher resolution of intracranial and intraorbital structures [42,43]. Various neuroimaging findings in diagnosis of pediatric IIH are best assessed with MRI of the head and orbits. These include posterior globe flattening (56% sensitivity and 100% specificity), intraocular protrusion of the optic nerve (40% sensitivity and 100% specificity), and horizontal tortuosity of the optic nerve (68% sensitivity and 83% specificity). In the patients with IIH, optic nerve sheath was enlarged compared with those in the control group (mean 4.3 versus 3.2 mm), and pituitary gland size is found to be smaller in the patients with IIH compared with those in the control group (mean 3.63 versus 5.05 mm) [43]. Administration of IV contrast can help in characterization of the intracranial space occupying lesion (when detected).
Orbital Imaging and Vision Loss Child. CT Orbits There is no relevant literature to support the use of CT orbits in the initial evaluation of children with papilledema or suspected raised intracranial pressure. CTA Head There is no relevant literature to support the use of CTA head in the initial evaluation of children with papilledema or suspected raised intracranial pressure. CTV Head CT venography (CTV) of the head may be an alternative to MR venography (MRV) for the evaluation of cerebral venous sinuses [42]. MRA Head There is no relevant literature to support the use of MRA head in the initial evaluation of children with papilledema or suspected raised intracranial pressure. MRI Head and Orbits MRI of the head and orbits is the most useful imaging modality for initial evaluation of the child presenting with papilledema and signs of raised intracranial pressure by detection of intracranial space occupying lesion or hydrocephalus. MRI is more useful over CT in children because of the ability of MRI to provide a higher resolution of intracranial and intraorbital structures [42,43]. Various neuroimaging findings in diagnosis of pediatric IIH are best assessed with MRI of the head and orbits. These include posterior globe flattening (56% sensitivity and 100% specificity), intraocular protrusion of the optic nerve (40% sensitivity and 100% specificity), and horizontal tortuosity of the optic nerve (68% sensitivity and 83% specificity). In the patients with IIH, optic nerve sheath was enlarged compared with those in the control group (mean 4.3 versus 3.2 mm), and pituitary gland size is found to be smaller in the patients with IIH compared with those in the control group (mean 3.63 versus 5.05 mm) [43]. Administration of IV contrast can help in characterization of the intracranial space occupying lesion (when detected).