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30b - Answer: 29-year-old female presents with a history of papilledema

Pomeranz, Stephen
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
Includes DICOM files

HISTORY: 

This 29-year-old female presents with a history of papilledema.

(QUIZ ANSWER) PRIMARY FINDING: 

Benign intracranial hypertension (pseudotumor cerebri).

Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.

FINDINGS:

Low lying morphologically normal cerebellar tonsils. 

Partial empty sella turcica. 

Optic nerve sheaths are dilated and the left optic nerve papilla indents the posterior globe. 

Ventricles are normal in size. 

Normal appearing white matter. 

Normal vascular flow voids at the base of the brain. 

No evidence of restricted diffusion or other evidence of regional infarct. 

No evidence of mass. 

CP angle cisterns, cochlea, vestibule, and 7th and 8th nerve complexes are unremarkable. 

Unremarkable paranasal sinuses and mastoid air cells. 

CONCLUSION: 

The combination of partial empty sella turcica and dilated optic nerve sheaths with indentation of the posterior globe by the optic nerve papilla is highly suggestive if not diagnostic of benign intracranial hypertension (formerly known as pseudotumor cerebri).

LESSON 3, TOPIC 60

Case Challenge: Brain MRI Cases

Case Challenge

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Content reviewed: July 23, 2021

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