Optic Nerve Tortuosity in Idiopathic Intracranial Hypertension.

A 61-year-old asymptomatic thin man was referred to our hospital for bilateral congestive papillae during a regular medical check-up. After performing brain magnetic resonance imaging, neither a mass lesion nor an empty sella were found; however, bilateral optic nerve tortuosity was detected, and a lumbar puncture was performed. The initial pressure exceeded 330 mmH2O; however, the cerebrospinal fluid cell counts and protein levels were normal. Therefore, the patient was diagnosed with idiopathic intracranial hypertension (IIH).

Optic nerve tortuosity (Picture) is considered to be a characteristic imaging finding seen in IIH cases. Although this finding has low sensitivity, the specificity is very high (80.8-95.0%) (1). Hence, patients with this imaging finding have a high probability of IIH. Headaches are the most frequent symptom of IIH (75-95%) (2), but it does not occur always. Therefore, this imaging finding may help diagnose IHH patients without headaches.

Picture.

The authors state that they have no Conflict of Interest (COI).