Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein - Campus Kiel, Germany.
Rofo. 2021 Nov;193(11):1269-1276. doi: 10.1055/a-1447-0264. Epub 2021 May 12.
Pseudotumor cerebri, also known as idiopathic intracranial hypertension, is a disorder of increased intracranial pressure of unknown etiology. Main symptom is headache which has a characteristic similar to other headache diseases, therefore the idiopathic intracranial hypertension often remains undetected. The incidence is 1/100 000 with the number of unreported cases being much higher. This article highlights the essential role of MRI in the differential diagnosis.
A literature search was carried out on idiopathic intracranial hypertension and Pseudotumor cerebri in English and German. Original and Review articles as well as case reports were taken into account. Since the main focus of the article is MRI diagnostics, some images were selected to illustrate the characteristic MRI morphological features.
The diagnosis of idiopathic intracranial hypertension is based on an exclusion procedure. Most common syndromes are headache, transient visual obscurations, pulsatile tinnitus and nausea. In the presence of an underlying cause for the increased intracranial pressure one speaks of a secondary intracranial hypertension. The diagnostics include a detailed medical history, neurological and ophthalmic examination, lumbar puncture, and neuroradiological imaging procedures. MRI, in particular, has become increasingly important in recent years, since signs for changes in cerebrospinal fluid pressure are now detectable and well-defined. The therapeutic approaches are symptom-oriented and aim to lower the pressure. With a precise diagnosis and timely start of therapy, idiopathic intracranial hypertension has a good prognosis, especially with regard to the preservation of eyesight.
· The idiopathic intracranial hypertension is an important differential diagnosis for unspecific headache and impaired vision. · Overweight women in childbearing age are particularly affected. · The most important component in diagnostics is MRI.
· Juhász J, Hensler J, Jansen O. MRT-Befunde bei der idiopathischen intrakraniellen Hypertension (Pseudotumor cerebri). Fortschr Röntgenstr 2021; 193: 1269 - 1276.
假性脑瘤，又称特发性颅内高压，是一种不明原因的颅内压升高疾病。主要症状是头痛，其特征与其他头痛疾病相似，因此特发性颅内高压常常未被发现。发病率为 1/100000，未报告的病例数量要高得多。本文强调了 MRI 在鉴别诊断中的重要作用。
用英语和德语对特发性颅内高压和假性脑瘤进行了文献检索。纳入了原始和综述文章以及病例报告。由于本文的主要重点是 MRI 诊断，因此选择了一些图像来说明特征性的 MRI 形态特征。
特发性颅内高压的诊断基于排除程序。最常见的综合征是头痛、短暂性视力障碍、搏动性耳鸣和恶心。在颅内压升高有潜在原因的情况下，称为继发性颅内高压。诊断包括详细的病史、神经学和眼科检查、腰椎穿刺和神经放射影像学检查。近年来，MRI 越来越重要，因为现在可以检测到并明确脑脊液压力变化的迹象。治疗方法是针对症状的，旨在降低压力。通过精确的诊断和及时开始治疗，特发性颅内高压的预后良好，特别是在保持视力方面。
·特发性颅内高压是不明原因头痛和视力障碍的重要鉴别诊断。·超重的育龄妇女受影响尤其大。·诊断中最重要的组成部分是 MRI。
