Diffusion Perfusion MRI in Idiopathic Pseudotumor Cerebri

Abstract

OBJECTIVE: Pseudotumor cerebri (PC) or idiopathic benign

intracranial hypertension is characterized by abnormal elevation of

intracranial pressure with a normal composition of the cerebrospinal

fluid (CSF) and absence of hydrocephaly or any intracranial mass lesion.

Papilledema is the major clinical finding whereas neuroradiological

imaging findings are almost always normal

METHODS: In this preliminary study, we aimed to find out whether

diffusion and perfusion magnetic resonance (MR) imaging in PC patients

might be beneficial in the diagnosis.

RESULTS: We prospectively evaluated diffusion and perfusion MR

findings of 10 PC patients and 10 normal control group. On physical

examination, all PC patients had characteristic papilledema, varying

degrees of headache, blurred vision and tinnitus. Cerebrospinal fluid

(CSF) pressure was higher than 250mm H2O in all patients. MR imaging

was performed with a 1.5 tesla equipment and postprocess analyses

were done on an independent workstation.

There were no diffusion abnormalities in CP patients or differences

when compared to normal group. Perfusion abnormal ities were

detected in seven patients.

CONCLUSION: Pseudotumor cerebri is a clinical syndrome which requires prompt diagnosis and thorough evaluation. Treatment is crucial for

preventing visual loss and improving associated symptoms. Since

majority of the patients lack specific neuroradiological imaging findings,

the syndrome is mostly diagnosed based on the clinical findings.

Probably due to the latter factor, there is almost no major paper in the

literature concerning the neuroradiologic aspects of the syndrome.

Although our patient series is very limited for statistical evaluation,

broader series might put forward additional benefit of perfusion MR

imaging in diagnosis of pseudotumor cerebri.