Ertuğrul UZAR, Faysal EKİCİ, Alparslan ŞAHİN, Yusuf TAMAM, Abdullah ACAR, Nebahat TAŞDEMİR

Behçet hastalığına bağlı psödotümör serebride kraniyal manyetik rezonans görüntülemesinde optik sinir kılıfında sıvı artışı

Psödotümör serebri Behçet hastalığında ender görülen bir durumdur. Optik sinir kılıfında genişleme ve optik sinir etrafında subaraknoid aralıkta sıvı artışı, psödotümör serebrili hastalarda nadir gözlenen manyetik rezonans (MR) bulgularıdır. Bildiğimiz kadarıyla Behçet hastalığına bağlı psödotümör serebride bu bulgular literatürde bildirilmemiştir. Bu tür olgularda lumboperitoneal şant cerrahisi medikal tedaviye yanıt alınamadığında ve görme semptomları varlığında uygulanabilmektedir. Bu yazıda, ilgili radyolojik ve klinik bulgular tartışıldı ve tedavi yöntemleri kısaca gözden geçirilmiştir.

Anahtar Kelimeler:

Behçet hastalığı, optik sinir görüntüleme, psödotümör serebri

Pseudotumor cerebri due to Behçet's disease increased fluid in the perioptic nerve sheath on cranial magnetic resonance imaging

Pseudotumor cerebri is a rare condition of Behçet's disease. Enlargement of optic nerve sheath and increased subarachnoid fluid around the optic nerve are uncommon magnetic resonance (MR) findings of the patients with pseudotumor cerebri. To the best of our knowledge, these findings were not reported in pseudotumor cerebri due to Behçet's disease. Lumboperitoneal shunting surgery may be performed in cases which have visual symptoms and refractory to the medical treatment. In this paper, the relevant clinical and radiological findings were discussed, and a brief overview of therapeutic management was provided.

Keywords:

-,

PDF

___

1. Palacio E, Rodero L, Pascual J. Topiramate-responsive headache due to idiopathic intracranial hypertension in Behçet syndrome. Headache 2004;44(5):436-7.
2. Hutzelmann A, Buhl R, Freund M. Pseudotumour cerebri and optic hydrops--magnetic resonance imaging diagnostic and therapeutical considerations in a paediatric case. Eur J Radiol. 1998;28(2):126-8.
3. Brazis PW. Surgery for idiopathic intracranial hypertension. J Neuroophthalmol 2009;29(4):271-4.
4. Siva A, Saip S. The spectrum of nervous system involvement in Behçet's syndrome and its differential diagnosis. J Neurol 2009;256(4):513-29.
5. Erdem H, Dinç A, Pay S, Simşek I, Uysal Y. A neuro-Behçet's case complicated with intracranial hypertension successfully treated by a lumboperitoneal shunt. Joint Bone Spine 2006;73(2):200-1.
6. Houman MH, Hamzaoui-B'Chir S, Ben Ghorbel I, Lamloum M, Ben Ahmed M, Abdelhak S, Miled M. Neurologic manifestations of Behcet's disease: analysis of a series of 27 patients. Rev Med Interne 2002;23(7):592-606.
7. Brodsky MC, Vaphiades M. Magnetic resonance imaging in pseudotumor cerebri. Ophthalmology 1998;105(9):1686-93.
8. Silbergleit R, Junck L, Gebarski SS, Hatfield MK. Idiopathic intracranial hypertension (pseudotumor cerebri): MR imaging. Radiology 1989;170 (1 Pt 1):207-9.
9. Degnan AJ, Levy LM. Narrowing of Meckel's cave and cavernous sinus and enlargement of the optic nerve sheath in Pseudotumor Cerebri. J Comput Assist Tomogr 2011;35(2):308- 12.
10. Gass A, Barker GJ, Riordan-Eva P, MacManus D, Sanders M, Tofts PS, McDonald WI, Moseley IF, Miller DH. MRI of the optic nerve in benign intracranial hypertension. Neuroradiology 1996;38(8):769-73.