title: Novel Magnetic Resonance Imaging Findings in Children With Intracranial Hypertension.
abstract: BACKGROUND
  Increased intracranial hypertension is defined as elevated intracranial pressure with absence of hydrocephalus, vascular or structural abnormalities, and normal cerebrospinal fluid content. Magnetic resonance imaging abnormalities of the optic nerve and sheath that have been described in adults include increased nerve tortuosity, flattening in posterior aspect of globe, intraocular protrusion of the optic nerve, and enlarged optic nerve sheath.
  
  
  OBJECTIVE
  We evaluated accuracy of those proposed markers on magnetic resonance imaging in children with increased intracranial hypertension that are described in adults.
  
  
  METHODS
  Eleven patients between 3 and 15 years of age with intracranial hypertension were selected for re-evaluation of magnetic resonance imaging that had been previously described as normal to determine the presence of: (1) increased tortuosity and elongation of the optic nerve; (2) enlargement of the optic nerve sheath on axial and coronal T2 so called by us "target sign" and postcontrast T1 sequences; (3) flattening in posterior aspect of the globe; and (4) intraocular protrusion of the optic nerve head.
  
  
  RESULTS
  Of the 11 patients, tortuosity of the optic nerve (10/11, 90.9%) and enlarged optic nerve sheath--target sign (7/11, 63.6%)--were the most common findings. Flattening in the posterior aspect of globe (5/11, 45.5%) and intraocular protrusion (3/11, 27.3%) were also detected as a novel magnetic resonance imaging findings.
  
  
  CONCLUSIONS
  Magnetic resonance imaging findings of the optic nerve and sheath include valuable signs of intracranial hypertension not only in adults but also in children. This is the first detailed analysis of the magnetic resonance imaging findings in children with increased intracranial hypertension.
authors.affiliation: Department of Pediatric Neurology, School of Medicine, Gazi University, Ankara, Turkey. Electronic address: tugbahirfanoglu@yahoo.com.
authors.forename: Tugba
authors.initials: T
authors.lastname: Hirfanoglu
authors.affiliation: Department of Pediatric Neurology, School of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Kursad
authors.initials: K
authors.lastname: Aydin
authors.affiliation: Department of Pediatric Neurology, School of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Serdaroglu
authors.affiliation: Department of Pediatric Neurology, School of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Havali
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D009900:Optic Nerve / Q000473:pathology
keywords: MRI findings; children; increased intracranial pressure; intracranial hypertension