title: Meningoceles in idiopathic intracranial hypertension.
abstract: OBJECTIVE
  MRI abnormalities have been described in patients with increased intracranial pressure (ICP), including in those with idiopathic intracranial hypertension (IIH). Spontaneous CSF-filled outpouchings of the dura (meningoceles) and secondary CSF leaks can occur from elevated ICP in patients with IIH; however, few studies have evaluated these findings. Our objective was to evaluate the frequency of spontaneous intracranial meningoceles among IIH patients and determine their association with visual outcome.
  
  
  METHODS
  We performed a retrospective case-control study of consecutive IIH patients between 2000 and 2011 who underwent MRI that included T2-weighted imaging. Demographics, presenting symptoms, CSF opening pressure, and visual outcome were collected for the first and last evaluations. Control subjects included patients without headache or visual complaints who had normal brain MRI results. Stratified analysis was used to control for potential confounding by age, sex, race, and body mass index.
  
  
  RESULTS
  We included 79 IIH patients and 76 control subjects. Meningoceles were found in 11% of IIH patients versus 0% of control subjects (p<0.003). Prominent Meckel caves without frank meningoceles were found in 9% of IIH patients versus 0% of control subjects (p<0.003). Among IIH patients, the presence of meningocele or prominent Meckel caves was not associated with demographics, symptoms, degree of papilledema, CSF opening pressure, visual acuity, or visual field defect severity.
  
  
  CONCLUSIONS
  Meningoceles are significantly more common in IIH patients than in control subjects and can be considered an additional imaging sign for IIH. Meningoceles are not, however, associated with decreased CSF opening pressure or better visual outcome in IIH.
authors.affiliation: 1 Department of Ophthalmology, Emory University Hospital, Emory University School of Medicine, Atlanta, GA.
authors.forename: Omer Y
authors.initials: OY
authors.lastname: Bialer
authors.forename: Mario Perez
authors.initials: MP
authors.lastname: Rueda
authors.forename: Beau B
authors.initials: BB
authors.lastname: Bruce
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Newman
authors.forename: Valérie
authors.initials: V
authors.lastname: Biousse
authors.forename: Amit M
authors.initials: AM
authors.lastname: Saindane
mesh_terms: D000328:Adult; D015984:Causality; D015897:Comorbidity; D004677:Encephalocele / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008588:Meningocele / Q000453:epidemiology* / Q000473:pathology*; D011559:Pseudotumor Cerebri / Q000453:epidemiology* / Q000473:pathology*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055815:Young Adult