Saudi Journal of Radiology
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Saudi Journal of Radiology

Volume 1, 2022 · Issue 1st Issue · Open Access · Double-blind Peer-review

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Original Research Article

Can ‘SOVAC’- a set of brain magnetic resonance imaging findings- detect idiopathic intracranial hypertension?

Khawaja bilal Waheed1, Ali Al Orf2, Faisal Mohammad Alzahrani2, Nawaf Nasser Aljubair2, Hussain Hadi Sharahili2, Adeel Qamar2 & Jebasingh Muthaian2

1 King Fahad Military Medical Complex Dhahran

2 Radiology Department, King Fahad Military Medical Complex, Saudi Arabia, Dhahran.

Published: 05 May 2026

https://doi.org/10.55038/sjr.v1i1.40
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Abstract

Objective
To determine diagnostic ability of brain magnetic resonance imaging (MRI) in detection of idiopathic intracranial hypertension (IIH).

Method

This descriptive observational study was conducted in radiology department from Jan. 2018 to Jan. 2021, evaluating MR imaging data of all adult patients (n=107) with clinical presentations of headaches. Patients with space occupying lesions, obstructive hydrocephalus and cerebral venous sinus thrombosis were excluded. Presence of all three brain MRI findings of (i) an empty sella (with or without sellar enlargement), (ii) tortuosity of optic nerves (with or without perioptic CSF prominence) and (iii) non-dilated (or slit-like) ventricles was considered positive for IIH. Imaging was reviewed by two neuroradiologists and consensus reporting was made. Findings of IIH were confirmed by presence of high lumbar opening cerebrospinal fluid (CSF) pressure or symptomatic response towards specific medical treatment. Outcomes of brain MRIs were presented on a 2x2 contingency table.

Results

Sensitivity, and specificity of routine brain MRI findings in detection of IIH were calculated as 76.4% [95% confidence interval (CI), 64.62-85.91%], and 84.6% (95% CI, 69.47-94.14%) respectively.  

Conclusion:
IIH is a known cause of headache. Detection of all three findings of empty sella, tortuosity of optic nerves and non-dilated ventricles on routine brain MRI can predict IIH with greater sensitivity and specificity.

KeywordsHeadacheIdiopathic Intracranial HypertensionMagnetic Resonance Imaging

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This work is licensed under a Creative Commons Attribution 4.0 International license

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