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MR imaging findings in children with pseudotumor cerebri and comparison with healthy controls

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Abstract

Objective

The aim of this study was to discuss the MR imaging findings of pseudotumor cerebri in children by comparing with healthy controls.

Materials and methods

Forty-two pseudotumor cerebri patients from hospital records between 2003 and 2011 were retrospectively reviewed. Between 2007 and 2011 25 patients (16 boys, 9 girls) whose brain MR images were on PACS workstation were included. Thirty MR imaging examinations (14 boys, 16 girls) which were interpreted as normal constituted the control group. Two pediatric radiologists reviewed each MRI for optic nerve sheath distension, intraocular protrusion of the optic nerve, posterior globe flattening, horizontal tortuosity of the optic nerve, and decreased pituitary gland size. The sensitivity, specificity, and overall accuracy of the findings on MRI were calculated.

Results

Optic nerve sheath enlarged in the PTC group (mean value, 4.3 mm) than in the control group (mean value, 3.2 mm). It had 88 % sensitivity and 80 % specificity. Pituitary gland size was decreased in PTC group (mean value, 3.63 mm) than in the control group (mean value, 5.05 mm). It had a sensitivity of 64 % and specificity of 90 %. Posterior globe flattening had 56 % sensitivity and 100 % specificity, intraocular protrusion of the optic nerve had 40 % sensitivity and 100 % specificity, and horizontal tortuosity of the optic nerve had 68 % sensitivity and 83 % specificity.

Conclusions

According to our study, posterior globe flattening, intraocular protrusion of the optic nerve, horizontal nerve sheath tortuosity, optic nerve sheath distension, and decreased pituitary gland size are reliable neuroradiological diagnostic markers for pediatric pseudotumor cerebri.

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References

  1. Per H, Canpolat M, Gümüs H, Poyrazoðlu HG, Yikilmaz A, Karaküçük S, Dogan H, Kumandas S (2013) Clinical spectrum of the pseudotumor cerebri in children: etiological, clinical features, treatment and prognosis. Brain Dev 35:561–568

    Article  PubMed  Google Scholar 

  2. Gordon K (1997) Pediatric pseudotumor cerebri: descriptive epidemiology. Can J Neurol Sci 24:219–221

    CAS  PubMed  Google Scholar 

  3. Ko MW, Liu GT (2010) Pediatric idiopathic intracranial hypertension (pseudotumor cerebri). Horm Res Paediatr 74:381–389

    Article  CAS  PubMed  Google Scholar 

  4. Rangwala LM, Liu GT (2007) Pediatric idiopathic intracranial hypertension. Surv Ophthalmol 52:597–617

    Article  PubMed  Google Scholar 

  5. Smith JL (1985) Whence pseudotumor cerebri? J Clin Neuro-Ophthalmol 5:55–56

    CAS  Google Scholar 

  6. Friedman DI, Jacobson DM (2004) Idiopathic intracranial hypertension. J Neuroophthalmol 24:138–145

    Article  PubMed  Google Scholar 

  7. Lim MJ, Pushparajah K, Jan W, Calver D, Lin JP (2010) Magnetic resonance imaging changes in idiopathic intracranial hypertension in children. J Child Neurol 25:294–299

    Article  PubMed  Google Scholar 

  8. Maralani PJ, Hassanlou M, Torres C, Chakraborty S, Kingstone M, Patel V, Zackon D, Bussière M (2012) Accuracy of brain imaging in the diagnosis of idiopathic intracranial hypertension. Clin Radiol 67:656–663

    Article  CAS  PubMed  Google Scholar 

  9. Hoffmann J, Huppertz HJ, Schmidt C (2013) Morphometric and volumetric MRI changes in idiopathic intracranial hypertension. Cephalalgia 33:1075–1084

    Article  PubMed  Google Scholar 

  10. Butros SR, Goncalves LF, Thompson D, Agarwal A, Lee HK (2012) Imaging features of idiopathic intracranial hypertension, including a new finding: widening of the foramen ovale. Acta Radiol 53:682–688

    Article  PubMed  Google Scholar 

  11. Shofty B, Ben-Sira L, Constantini S, Freedman S, Kesler A (2012) Optic nerve sheath diameter on MR imaging: establishment of norms and comparison of pediatric patients with idiopathic intracranial hypertension with healthy controls. AJNR Am J Neuroradiol 33:366–369

    Article  CAS  PubMed  Google Scholar 

  12. Degnan AJ, Levy LM (2011) Pseudotumor cerebri: brief review of clinical syndrome and imaging findings. AJNR Am J Neuroradiol 32:1986–1993

    Article  CAS  PubMed  Google Scholar 

  13. Brodsky MC (2004) Flattening of the posterior sclera: hypotony or elevated intracranial pressure? Am J Ophthalmol 138:511

    Article  PubMed  Google Scholar 

  14. Mandelstam S, Moon A (2004) MRI of optic disc edema in childhood idiopathic intracranial hypertension. Pediatr Radiol 34:362

    Article  PubMed  Google Scholar 

  15. Brodsky MC, Vaphiades M (1998) Magnetic resonance imaging in pseudotumor cerebri. Ophthalmology 105:1686–1693

    Article  CAS  PubMed  Google Scholar 

  16. Agid R, Farb RI, Willinsky RA, Mikulis DJ, Tomlinson G (2006) Idiopathic intracranial hypertension: the validity of cross-sectional neuroimaging signs. Neuroradiology 48:521–527

    Article  CAS  PubMed  Google Scholar 

  17. Madill SA, Connor SE (2005) Computed tomography demonstrates short axial globe length in cases with idiopathic intracranial hypertension. J Neuroophthalmol 25:180–184

    Article  PubMed  Google Scholar 

  18. Yuh WT, Zhu M, Taoka T, Quets JP, Maley JE, Muhonen MG, Schuster ME, Kardon RH (2000) MR imaging of pituitary morphology in idiopathic intracranial hypertension. J Magn Reson Imaging 12:808–813

    Article  CAS  PubMed  Google Scholar 

  19. Sallomi D, Taylor H, Hibbert J, Sanders MD, Spalton DJ, Tonge K (1998) The MRI appearance of the optic nerve sheath following fenestration for benign intracranial hypertension. Eur Radiol 8:1193–1196

    Article  CAS  PubMed  Google Scholar 

  20. Lai LT, Danesh-Meyer HV, Kaye AH (2014) Visual outcomes and headache following interventions for idiopathic intracranial hypertension. J Clin Neurosci 21:1670–1678

    Article  PubMed  Google Scholar 

  21. Connor SE, Siddiqui MA, Stewart VR, O’Flynn EA (2008) The relationship of transverse sinus stenosis to bony groove dimensions provides an insight into the aetiology of idiopathic intracranial hypertension. Neuroradiology 50:999–1004

    Article  CAS  PubMed  Google Scholar 

  22. Higgins JN, Gillard JH, Owler BK, Harkness K, Pickard JD (2004) MR venography in idiopathic intracranial hypertension: unappreciated and misunderstood. J Neurol Neurosurg Psychiatry 75:621–625

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Manfré L, Lagalla R, Mangiameli A, Lupo F, Giuffré G, Ponte F, Cardinale AE (1995) Idiopathic intracranial hypertension: orbital MRI. Neuroradiology 37:459–461

    Article  PubMed  Google Scholar 

  24. Rogers DLA (2014) Review of pediatric idiopathic intracranial hypertension. Pediatr Clin North Am 61:579–590

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to express our appreciations to Prof. Dr. Ayşe Öner and Prof. Dr. Hakkı Doğan for their opthalmogical examinations of our patients.

Conflict of interest

The authors have no conflict of interest.

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Correspondence to Süreyya Burcu Görkem.

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Görkem, S.B., Doğanay, S., Canpolat, M. et al. MR imaging findings in children with pseudotumor cerebri and comparison with healthy controls. Childs Nerv Syst 31, 373–380 (2015). https://doi.org/10.1007/s00381-014-2579-0

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  • DOI: https://doi.org/10.1007/s00381-014-2579-0

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