Neuroimaging: idiopathic intracranial hypertension: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: idiopathic intracranial hypertension

Sample item

An obese young woman has headache and papilloedema, with a normal CT. MRI shows a flattened pituitary with CSF in the sella, dilated optic nerve sheaths, posterior globe flattening and transverse sinus stenosis. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Idiopathic intracranial hypertension

Raised intracranial pressure transmitted through the optic sheaths and sella gives an empty or partially empty sella, distended perioptic subarachnoid space, flattened posterior globe and transverse sinus stenosis. Ventricles are normal or small. Apoplexy gives an enlarged haemorrhagic pituitary, and normal pressure hydrocephalus gives large ventricles.

Option by option

  • A. Cavernous sinus thrombosis

    Cavernous sinus thrombosis causes proptosis, ophthalmoplegia and an enlarged sinus.

  • B. Pituitary apoplexy

    Apoplexy enlarges the pituitary with haemorrhage and a sudden headache.

  • C. Normal pressure hydrocephalus

    Normal pressure hydrocephalus shows enlarged ventricles in an older patient with gait problems.

  • D. Idiopathic intracranial hypertension (correct)

    Correct. These signs of raised pressure in an obese young woman fit IIH.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Idiopathic intracranial hypertension. Raised intracranial pressure transmitted through the optic sheaths and sella gives an empty or partially empty sella, distended perioptic subarachnoid space, flattened posterior globe and transverse sinus stenosis.

Why is "Cavernous sinus thrombosis" not the answer?

Cavernous sinus thrombosis causes proptosis, ophthalmoplegia and an enlarged sinus.

Why is "Pituitary apoplexy" not the answer?

Apoplexy enlarges the pituitary with haemorrhage and a sudden headache.

Why is "Normal pressure hydrocephalus" not the answer?

Normal pressure hydrocephalus shows enlarged ventricles in an older patient with gait problems.

What concept does this question test?

It tests Neuroimaging: idiopathic intracranial hypertension in Radiology. Ventricles are normal or small. Apoplexy gives an enlarged haemorrhagic pituitary, and normal pressure hydrocephalus gives large ventricles.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: idiopathic intracranial hypertension?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.