Aims and objectives
Tortuous optic nerves (TON) are abnormally curvatured optic nerves.
These are easily detectable changes even on brain MRI scans.
Based on the literature optic nerve (ON) becomes tortuous in case of intracranial hypertension .
TON is an often reported MRI finding in bening intracranial hypertension (BIH) [1-4],
but only a few studies mentioned TON associated with sinus thrombosis or Chiari malformation [5,6].
tortuous optic nerve can be associated with diseases without clinical...
Methods and materials
50 consecutive TON patients’ MR studies were examined retrospectively.
There were 23 female and 27 male,
ranging in age from 1 to 83 years (mean: 33 years).
We established the existence and degree of optic nerve tortuosity on 3-plain MR images based on Armstrong's recommendations (Fig. 1) .
MR images were acquired with 1.5 T GE Signa Excite HDxt MR Scanner (GE Healthcare,
In axial plane we observed T2 FSE sequences (TR:>2500 msec,
TE: 85 msec,
24% (n=12) of TON patients belonged to the CSF group ( Fig. 2 ).
In the patients of this group,
hydrocephalus developed due to different origins,
meningitis or subarachnoideal haemorrhage.
In the BV group,
16% (n=8) of the TON patients were diagnosed with sinus thrombosis or BIH with sinus stenosis.
Space occupying laesion (SOL) was detected in 36% (n=18) of the cases.
12% (n=6) of TON patients was diagnosed with type 1 neurofibromatosis (NF1) ( Fig. 3 ).
Other (O) developmental...
Optic nerve tortuosity develops not only in intracranial hypertension of different causes and in NF-1 patients,
but also in cases without obvious intracranial pressure elevation.
It can not be considered as a specific sign,
but may draw attention – if the well-known associations can be excluded - to some rarer pathologies such as local orbital lesions.
It might also raise the possibility of the causative relationship between the Chiari malformation and increased ICP.
1: Department of Radiology,
Affidea Diagnostics Ltd.
Hungary - Szeged/HU
2: Department of Radiology,
Faculty of Medicine,
University of Szeged- Szeged/HU
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