MR Imaging Findings in Children with Pseudotumor Cerebri and Comparison with Healthy Controls

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2014 Nov 1

PMID 25358812

Citations 12

Authors

Sureyya Burcu Gorkem

Selim Doganay

Mehmet Canpolat

Gonca Koc

Mehmet S Dogan

Huseyin Per

Abdulhakim Coskun

Affiliations

Soon will be listed here.

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.

Citing Articles

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Transorbital B-mode ultrasound for the assessment of posterior globe flattening in idiopathic intracranial hypertension: a pilot study.

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References

Maralani P, Hassanlou M, Torres C, Chakraborty S, Kingstone M, Patel V . Accuracy of brain imaging in the diagnosis of idiopathic intracranial hypertension. Clin Radiol. 2012; 67(7):656-63. DOI: 10.1016/j.crad.2011.12.002. View

Mandelstam S, Moon A . MRI of optic disc edema in childhood idiopathic intracranial hypertension. Pediatr Radiol. 2004; 34(4):362. DOI: 10.1007/s00247-003-1121-4. View

Madill S, Connor S . Computed tomography demonstrates short axial globe length in cases with idiopathic intracranial hypertension. J Neuroophthalmol. 2005; 25(3):180-4. DOI: 10.1097/01.wno.0000177302.90586.16. View

Rogers D . A review of pediatric idiopathic intracranial hypertension. Pediatr Clin North Am. 2014; 61(3):579-90. DOI: 10.1016/j.pcl.2014.03.004. View

Friedman D, Jacobson D . Idiopathic intracranial hypertension. J Neuroophthalmol. 2004; 24(2):138-45. DOI: 10.1097/00041327-200406000-00009. View

Smith J . Whence pseudotumor cerebri?. J Clin Neuroophthalmol. 1985; 5(1):55-6. View

Brodsky M, Vaphiades M . Magnetic resonance imaging in pseudotumor cerebri. Ophthalmology. 1998; 105(9):1686-93. DOI: 10.1016/S0161-6420(98)99039-X. View

Hoffmann J, Huppertz H, Schmidt C, Kunte H, Harms L, Klingebiel R . Morphometric and volumetric MRI changes in idiopathic intracranial hypertension. Cephalalgia. 2013; 33(13):1075-84. DOI: 10.1177/0333102413484095. View

Manfre L, Lagalla R, Mangiameli A, Lupo F, Giuffre G, Ponte F . Idiopathic intracranial hypertension: orbital MRI. Neuroradiology. 1995; 37(6):459-61. DOI: 10.1007/BF00600093. View

10.

Sallomi D, Taylor H, Hibbert J, Sanders M, Spalton D, Tonge K . The MRI appearance of the optic nerve sheath following fenestration for benign intracranial hypertension. Eur Radiol. 1998; 8(7):1193-6. DOI: 10.1007/s003300050533. View

11.

Lai L, Danesh-Meyer H, Kaye A . Visual outcomes and headache following interventions for idiopathic intracranial hypertension. J Clin Neurosci. 2014; 21(10):1670-8. DOI: 10.1016/j.jocn.2014.02.025. View

12.

Rangwala L, Liu G . Pediatric idiopathic intracranial hypertension. Surv Ophthalmol. 2007; 52(6):597-617. DOI: 10.1016/j.survophthal.2007.08.018. View

13.

Yuh W, Zhu M, Taoka T, Quets J, Maley J, Muhonen M . MR imaging of pituitary morphology in idiopathic intracranial hypertension. J Magn Reson Imaging. 2000; 12(6):808-13. DOI: 10.1002/1522-2586(200012)12:6<808::aid-jmri3>3.0.co;2-n. View

14.

Brodsky M . Flattening of the posterior sclera: hypotony or elevated intracranial pressure?. Am J Ophthalmol. 2004; 138(3):511. DOI: 10.1016/j.ajo.2004.05.020. View

15.

Lim M, Pushparajah K, Jan W, Calver D, Lin J . Magnetic resonance imaging changes in idiopathic intracranial hypertension in children. J Child Neurol. 2009; 25(3):294-9. DOI: 10.1177/0883073809338874. View

16.

Shofty B, Ben-Sira L, Constantini S, Freedman S, Kesler A . 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. 2011; 33(2):366-9. PMC: 7964794. DOI: 10.3174/ajnr.A2779. View

17.

Connor S, Siddiqui M, Stewart V, OFlynn E . The relationship of transverse sinus stenosis to bony groove dimensions provides an insight into the aetiology of idiopathic intracranial hypertension. Neuroradiology. 2008; 50(12):999-1004. DOI: 10.1007/s00234-008-0431-5. View

18.

Butros S, Goncalves L, Thompson D, Agarwal A, Lee H . Imaging features of idiopathic intracranial hypertension, including a new finding: widening of the foramen ovale. Acta Radiol. 2012; 53(6):682-8. DOI: 10.1258/ar.2012.110705. View

19.

Per H, Canpolat M, Gumus H, Poyrazoglu H, Yikilmaz A, Karakucuk S . Clinical spectrum of the pseudotumor cerebri in children: etiological, clinical features, treatment and prognosis. Brain Dev. 2012; 35(6):561-8. DOI: 10.1016/j.braindev.2012.08.008. View

20.

Ko M, Liu G . Pediatric idiopathic intracranial hypertension (pseudotumor cerebri). Horm Res Paediatr. 2010; 74(6):381-9. DOI: 10.1159/000321180. View