Optic Nerve Sheath Enhancement in Patients with Intracranial Hypertension

Optic nerve sheath enhancement is a nonspecific radiologic sign typically found in infectious, inflammatory, and neoplastic disorders. This radiologic sign may rarely be found in patients with idiopathic intracranial hypertension. We describe four patients with idiopathic and/or secondary (presumed prior viral meningitis, doxycycline induced, and vitamin A induced) intracranial hypertension who had optic nerve sheath enhancement on magnetic resonance imaging. We postulate that optic nerve sheath enhancement may be an additional nonspecific radiologic sign of intracranial hypertension, regardless of its etiology, likely reflecting venous congestion.