MRI Findings in Pediatric Idiopathic Intracranial Hypertension: Evaluating the Oculomotor Nerve Sheath as a Potential New Diagnostic Marker

MRI Findings in Pediatric Idiopathic Intracranial Hypertension: Evaluating the Oculomotor Nerve Sheath as a Potential New Diagnostic Marker | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article MRI Findings in Pediatric Idiopathic Intracranial Hypertension: Evaluating the Oculomotor Nerve Sheath as a Potential New Diagnostic Marker Şükriye Yavuzer, Hasan Bulut, Berna Uçan, Sevde Seçer, Selda Çelik Dülger, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6319522/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 13 Jan, 2026 Read the published version in Child's Nervous System → Version 1 posted 8 You are reading this latest preprint version Abstract Purpose Consequently, the significance of neuroimaging in diagnosing pediatric IIH has grown substantially in recent years. This study aims to delineate the magnetic resonance imaging (MRI) findings in children diagnosed with idiopathic intracranial hypertension. Additionally, it introduces the evaluation of the oculomotor nerve cistern (OMC) as a potential novel imaging marker. Methods: Brain magnetic resonance imaging and magnetic resonance venography (MRV) scans from 66 patients aged 0 to 18, all presenting with clinical signs of increased intracranial pressure, were systematically reviewed. The following imaging parameters were evaluated on brain MRI: pituitary gland height and upper contour morphology, cerebrospinal fluid (CSF) distance surrounding the optic nerve, optic nerve tortuosity, posterior scleral flattening, and the oculomotor nerve cistern. Results Among the 66 patients in the study, elevated intracranial pressure and CSF expansion within the optic nerve sheath were the most sensitive imaging findings. When comparing various imaging findings, OMC enlargement demonstrated the second-highest sensitivity (52.2%) for detecting increased intracranial pressure, following optic nerve sheath CSF expansion. Conclusion: The findings from this study suggest that various MRI and MRV features may serve as reliable biomarkers for detecting elevated intracranial pressure. Notably, this study highlights the potential diagnostic utility of a newly identified imaging marker, cerebrospinal fluid expansion in the oculomotor nerve cistern, demonstrating significant sensitivity in distinguishing patients with increased intracranial pressure. Given its diagnostic value, we propose that OMC enlargement may be incorporated into future neuroimaging protocols for evaluating pediatric IIH. Keywords: Neuroimaging, İntracranial Hypertension, Children, Magnetic Resonance Venography Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 13 Jan, 2026 Read the published version in Child's Nervous System → Version 1 posted Editorial decision: Revision requested 19 Oct, 2025 Reviews received at journal 21 Aug, 2025 Reviewers agreed at journal 08 Aug, 2025 Reviewers agreed at journal 13 Jun, 2025 Reviewers invited by journal 10 Jun, 2025 Editor assigned by journal 02 Apr, 2025 Submission checks completed at journal 02 Apr, 2025 First submitted to journal 27 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6319522","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":469923771,"identity":"98bee7a8-ed3b-41e9-a57e-955e742b2e29","order_by":0,"name":"Şükriye Yavuzer","email":"","orcid":"","institution":"Department of Pediatric Radiology, Ankara Etlik City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Şükriye","middleName":"","lastName":"Yavuzer","suffix":""},{"id":469923772,"identity":"b44f24e1-e1a1-47bb-af09-6b785b0281bb","order_by":1,"name":"Hasan Bulut","email":"","orcid":"","institution":"Department of Pediatric 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This study aims to delineate the magnetic resonance imaging (MRI) findings in children diagnosed with idiopathic intracranial hypertension. Additionally, it introduces the evaluation of the oculomotor nerve cistern (OMC) as a potential novel imaging marker. \nMethods: Brain magnetic resonance imaging and magnetic resonance venography (MRV) scans from 66 patients aged 0 to 18, all presenting with clinical signs of increased intracranial pressure, were systematically reviewed. The following imaging parameters were evaluated on brain MRI: pituitary gland height and upper contour morphology, cerebrospinal fluid (CSF) distance surrounding the optic nerve, optic nerve tortuosity, posterior scleral flattening, and the oculomotor nerve cistern. \nResults Among the 66 patients in the study, elevated intracranial pressure and CSF expansion within the optic nerve sheath were the most sensitive imaging findings. When comparing various imaging findings, OMC enlargement demonstrated the second-highest sensitivity (52.2%) for detecting increased intracranial pressure, following optic nerve sheath CSF expansion. \nConclusion: The findings from this study suggest that various MRI and MRV features may serve as reliable biomarkers for detecting elevated intracranial pressure. Notably, this study highlights the potential diagnostic utility of a newly identified imaging marker, cerebrospinal fluid expansion in the oculomotor nerve cistern, demonstrating significant sensitivity in distinguishing patients with increased intracranial pressure. 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