Perioptic cerebro-spinal fluid transudation: case report of an unusual finding of optic hydrops in idiopathic intracranial hypertension

Abstract Background Idiopathic intracranial hypertension (IIH) has well-described imaging findings, typically reversible with the adequate treatment. We hereby report a case of IIH peculiar finding, that to our knowledge and by research conducted, never been described before—cerebro-spinal fluid (CSF) transudation across optic nerve sheath. Case presentation A 15-year-old girl 2-week history occipital headache, nausea vomiting, diplopia, blurred vision tinnitus in her right ear, was admitted neuropediatric department after extensive diagnostic work-up diagnosed IIH. The MRI showed typical signs idiopathic hypertension, including enlargement perioptic CSF spaces associated finding as hyperintensity T2/FLAIR fat, which likely related CSF. medical therapy (including corticosteroids acetazolamide) for 2 weeks didn’t revert symptoms so lumboperitoneal shunt placed complete resolution clinical picture findings described. Conclusions documentation around setting hydrops reported before should be recognized neuroradiologist. It seems reversible, like other its physiopathology is not clear.