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

Keywords

• pseudotumor cerebri
• diffusion MRI
• perfusion MRI