title: Intracanalicular Optic Nerve Swelling and Signal Change in Fulminant Untreated Idiopathic Intracranial Hypertension.
abstract: The role of the optic canal in the pathogenesis of papilloedema has been under scrutiny recently. Whether a larger canal precedes more severe papilloedema or is the result of bone remodelling from chronically raised pressure across a pressure gradient is not clear. The authors present the magnetic resonance imaging findings of a 29-year-old female with fulminant and untreated idiopathic intracranial hypertension. Imaging showed focal expansion and intrinsic signal changes of the intracanalicular optic nerve. The authors discuss the possibility of either fluid accumulation within the optic nerves from a water hammer effect across blocked optic canals resulting from the steep pressure gradient or opticomalacia (optic nerve softening) from chronic ischaemia.
authors.affiliation: Department of Neurology, Greys Hospital, Pietermaritzburg, South Africa; Department of Neurology, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Anand A
authors.initials: AA
authors.lastname: Moodley
authors.affiliation: Department of Neurology, Greys Hospital , Pietermaritzburg, South Africa.
authors.forename: Mahlubonke S
authors.initials: MS
authors.lastname: Dlwati
authors.affiliation: Department of Neurology, University of KwaZulu-Natal, Durban, South Africa; Department of Radiology, Greys Hospital, Pietermaritzburg, South Africa.
authors.forename: Miranda
authors.initials: M
authors.lastname: Durand
keywords: Idiopathic intracranial hypertension; optic canal; optic nerve compartmentalisation; papilloedema; peri-optic subarachnoid space