Lumbar Opening Pressure and Radiologic Scoring in Idiopathic Intracranial Hypertension: Is There Any Correlation?

Background: To investigate correlation between lumbar opening pressure (LOP) and radiological scores based on cranial MRI and contrast-enhanced MR venography in patients with idiopathic intracranial hypertension (IIH).

Material/methods: Patients with IIH who underwent brain MRI and contrast-enhanced MR venography before measurement of LOP between 2010-2014 were evaluated retrospectively. Three experienced radiologists (blinded to LOP values) evaluated a total of 51 patients. They reached a consensus on the presence or absence of 6 radiological findings identified in the literature as characteristic for IIH: empty sella, perioptic dilation, optical tortuosity, flattening of the posterior globe, swelling of the optic disc, and bilateral transverse sinus stenosis. The radiological score was obtained by giving 1 point for the presence of each finding, with the highest possible score of 6 points. The correlation between the calculated radiological scores and LOP was evaluated.

Results: There was no significant correlation between LOP and radiological scores (r=0.095; p=0.525, Spearman's rank coefficient). Similarly, no significant correlation was detected between LOP and each of the radiological findings (partial empty sella [p=0.137], perioptic dilation [p=0.265], optical tortuosity [p=0.948], flattening of the posterior globe [p=0.491], swelling of the optic disc [p=0.881], and bilateral dural sinus stenosis [p=0.837], Mann-Whitney U test).

Conclusions: There was no significant correlation between LOP and reliable radiological features of IIH.