Idiopathic intracranial hypertension: cranial magnetic resonance imaging findings correlation with direct venous sinus pressure measurements

Abstract

Objective: To establish the association between magnetic resonance imaging (MRI) findings and angiographic sinus manometry in idiopathic intracranial hypertension. Method: 21 cases of refractory to medical treatment idiopathic intracranial hypertension underwent angiographic direct venous pressure measurements to assess the indication of venous stenting and balloon angioplasty. Lumbar puncture opening pressure, MRI findings, and angiographic venous manometry data were co-llected and statistically analyzed. Results: Empty sella was significantly associated with venous sinus stenosis. Lumbar puncture opening pressure > 29 cmH2 O was associated with high venous sinus pressure and gradient. Conclusions: MRI detected sellar abnormalities, particularly the presence of empty sella, significantly correlated with venous sinus stenosis. The lumbar puncture opening pressure may provide a minimally invasive screening tool for venous sinus stenting or balloon angioplasty patient selection, to be further assessed by a larger sample study.