Role of neuroimaging markers on predicting of idiopathic intracranial hypertension

Comprehensive Summary

Idiopathic intracranial hypertension (IIH) is a condition in which neuroimaging plays a central role in excluding alternative diagnoses and guiding management. This study examined whether novel radiologic markers, such as Meckel’s cave area, provide additional predictive value alongside established imaging features like empty sella in identifying IIH. In a case-control design, 22 patients with IIH and 22 controls were compared based on cerebrospinal fluid opening pressure and evaluated for multiple imaging markers, including optic nerve sheath diameter, optic nerve tortuosity, scleral flattening, transverse sinus stenosis, Meckel’s cave area, and posterior neck fat measurements. The IIH group showed significantly higher rates of increased optic nerve sheath diameter, optic nerve tortuosity, scleral flattening, and transverse sinus stenosis, while Meckel’s cave area and posterior neck fat measurements did not differ between groups.

Outcomes and Implications

This work matters because early and accurate diagnosis of IIH depends heavily on reliable imaging markers. By confirming the diagnostic relevance of ophthalmic findings and transverse sinus stenosis while demonstrating limited value for Meckel’s cave enlargement and posterior neck fat measurements, the study helps refine radiologic criteria for IIH. These findings support more focused and precise imaging evaluation, potentially improving diagnostic accuracy and clinical decision-making in patients suspected of having IIH.