Several brain MR imaging findings have been associated with the diagnosis of idiopathic intracranial hypertension. Therefore, it is important to recognize and diagnose this condition clinically and on imaging studies as early as possible. The most concerning complication of untreated or treatment-resistant IIH is visual loss, which can progress rapidly and become irreversible once the patient becomes symptomatic. Symptoms may overlap those seen in migraine, and misdiagnosis creates delays that may have substantial comorbidities. 11 The prolonged debilitation and suffering associated with this condition can be substantial. Idiopathic intracranial hypertension in children can present with features less commonly seen in adults, most particularly signs of intracranial mass effect, including cranial nerve deficits, most notably in cranial nerve VI. Papilledema progressing to variable degrees of transient or permanent visual loss is a familiar but not necessarily a sine qua non manifestation. 9, 10 Headache is the most consistent symptom experienced by patients, though back and shoulder discomfort can be reported too. 4, 8 It is associated with the use of several medications, most notably vitamin A derivatives and tetracycline antibiotics. 1 The condition is known to be more prevalent in young adult women, especially those with an elevated body mass index, 2, 3 older men with obstructive sleep apnea, 4 ⇓ ⇓– 7 and patients with a variety of endocrine conditions. The diagnosis is established by the Modified Dandy Criteria, which, in essence, means an opening pressure at lumbar puncture of >250 mm of water in adults and >280 mm in children, with no definable etiology. Primary idiopathic intracranial hypertension (IIH), alternatively known as pseudotumor cerebri, is a little-understood condition characterized by unexplained elevation of intracranial pressure. ABBREVIATIONS: IIH idiopathic intracranial hypertension TS transverse sinus

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