Increased intra cranial tension.

A) History:

• 15 years old female patient with 2 weeks of history of headache; papilledema and bilateral 6th nerve palsy.

B) Images:

Image number 1

Image number 2

C) Image's types:

• Image number 1 is an MR brain axial T2 sequence image taken at the level of orbits.
• Image number 2 is an MR orbit image taken at the same level as image # 1.

D) Interpretation:

• Look to the posterior sclera at the site of insertion of the optic nerve where you can identify its flattening.
• You could find also protrusion of the optic disc (not seen in this case).
• Tortuosity of the intra ocular optic nerves.
• Increased peri optic nerve CSF with dilatation of optic sheaths.
• Empty sella (better seen on sagital view).

E) Diagnosis:

• Picture is suggestive of increased intra cranial tension.

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