JAMA Neurology-incidental intracranial hypertension, or lumbar puncture is not recommended

Signs of intracranial hypertension (IH) detected by magnetic resonance imaging (MRI), such as empty sella (empty sella), increased cerebrospinal fluid (CSF), optic nerve tortuosity, and rhabdominal sinus stenosis (TVSS), usually associated with idiopathic Intracranial hypertension (IIH) is related, but it is also present in patients with primary headache syndrome and asymptomatic patients

It is estimated that in the general patient population, the incidence of empty shells is between 8% and 35%, and it is more common in women and obese people

Patients who have incidentally detected MRI signs of IH are often referred to a neurology or neuro-ophthalmology clinic, and often undergo invasive procedures, such as lumbar puncture, because they are worried about IIH

Between 2002 and 2016, the incidence of IIH in England doubled, the corresponding number of hospital admissions increased by 442%, and direct medical expenses increased by 6 times

In this way, Benson S.

From August 1, 2019 to March 31, 2020, they conducted this prospective cross-sectional study on outpatients who received brain MRI examinations at outpatient imaging institutions, and took pictures of fundus at the same time

Main clinical outcomes: the prevalence of MRI signs of IH and the prevalence of nipple edema detected on fundus photographs

A total of 388 patients underwent eligibility screening; 92 of them were excluded

The most common indication of MRI is the monitoring of brain tumors (82 patients [27.

Of the total 296 patients in the study, 98 patients (33.

Six of the 198 patients (3.

Compared with patients without papillary edema, patients with papillary edema have a significantly higher body mass index and IIH history.

The important significance of this study is that it found that: Magnetic resonance imaging signs of IH are common in patients undergoing brain MRI, but they are rarely related to nipple edema

Original Source:
Chen BS, Meyer BI, Saindane AM, Bruce BB, Newman NJ, Biousse V.
Prevalence of Incidentally Detected Signs of Intracranial Hypertension on Magnetic Resonance Imaging and Their Association With Papilledema.
JAMA Neurol.
2021 Jun 1;78(6) :718-725.
doi: 10.
1001/jamaneurol.
2021.
0710.
PMID: 33871552; PMCID: PMC8056310.