{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:22:01Z","timestamp":1772119321920,"version":"3.50.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National University of Colombia"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The diagnostic accuracy of magnetic resonance (MRI) signs of intracranial hypertension (ICH) in children remains unclear. This study aims to assess how brain MRI signs of ICH correlate with cerebrospinal fluid opening pressure (CSFOP). A retrospective case\u2013control study was conducted with 77 children aged 1 to 18\u00a0years, who underwent brain MRI and lumbar puncture with CSFOP measurement. A blinded radiologist evaluated key ICH signs, including distension of the perioptic subarachnoid space, optic nerve (ON) tortuosity, posterior scleral flattening, intraocular protrusion, and enhancement of the prelaminar ON, among others. Odds ratios, likelihood ratios, predictive values, sensitivity, specificity, and the area under the ROC curve (AUROC), were calculated in relation to CSFOP, adjusted for age and sex. The ICH group included 38 patients (49.3%) and the control group 39 (50.7%). The presence of four or more MRI signs of ICH provided the best diagnostic performance (specificity 92%, sensitivity 40%, AUROC 0.759) for identifying elevated CSFOP, particularly with intraocular protrusion of the prelaminar ON (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.006, median CSFOP 49.6\u00a0cm H\n                    <jats:sub>2<\/jats:sub>\n                    O,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.001) and papilledema (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.042).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : The presence of four or more MRI signs is associated with elevated CSFOP in children with non-structural ICH.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What Is Known:<\/jats:bold>\n                              <jats:italic>\u2022 The diagnostic accuracy of magnetic resonance imaging (MRI) signs of intracranial hypertension (ICH) in children remains unclear.<\/jats:italic>\n                              <jats:italic>\u2022 In children, there is no consensus about the most appropriate diagnostic criteria or robust evidence regarding the diagnostic performance of imaging signs for ICH.<\/jats:italic>\n                              <jats:bold>What Is New:<\/jats:bold>\n                              <jats:italic>\u2022 The presence of four or more MRI signs is associated with elevated cerebrospinal fluid opening pressure (CSFOP) in children with non-structural ICH.<\/jats:italic>\n                              <jats:italic>\u2022 Intraocular protrusion of the prelaminar ON, and papilledema are particularly relevant signs for identifying elevated CSFOP.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-025-06025-8","type":"journal-article","created":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T05:53:22Z","timestamp":1740808402000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Magnetic resonance signs of intracranial hypertension in children: a retrospective case\u2013control study"],"prefix":"10.1007","volume":"184","author":[{"given":"Luz Angela","family":"Moreno-G\u00f3mez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Quintero-Pulgar\u00edn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar Mauricio","family":"Espitia Segura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leidy Carolina","family":"Chiquiza-Garz\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan David","family":"Farf\u00e1n-Albarrac\u00edn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina Lorena","family":"Ram\u00edrez-Sierra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yenny Carolina","family":"Zu\u00f1iga-Zambrano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leydi Alexandra","family":"Ceballos-Inga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,1]]},"reference":[{"issue":"9","key":"6025_CR1","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1056\/NEJMc1004957","volume":"363","author":"RA Avery","year":"2010","unstructured":"Avery RA, Shah SS, Licht DJ et al (2010) Reference range for cerebrospinal fluid opening pressure in children. N Engl J Med 363(9):891\u2013893. https:\/\/doi.org\/10.1056\/NEJMc1004957","journal-title":"N Engl J Med"},{"key":"6025_CR2","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.pediatrneurol.2016.08.010","volume":"66","author":"SC Aylward","year":"2017","unstructured":"Aylward SC, Reem RE (2017) Pediatric Intracranial Hypertension. Pediatr Neurol 66:32\u201343. https:\/\/doi.org\/10.1016\/j.pediatrneurol.2016.08.010","journal-title":"Pediatr Neurol"},{"issue":"13","key":"6025_CR3","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1212\/WNL.0b013e3182a55f17","volume":"81","author":"DI Friedman","year":"2013","unstructured":"Friedman DI, Liu GT, Digre KB (2013) Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 81(13):1159\u20131165. https:\/\/doi.org\/10.1212\/WNL.0b013e3182a55f17","journal-title":"Neurology"},{"key":"6025_CR4","doi-asserted-by":"publisher","unstructured":"Gilbert AL, Vaughn J, Whitecross S, Robson CD, Zurakowski D, Heidary G (2021) Magnetic resonance imaging features and clinical findings in pediatric idiopathic intracranial hypertension: a case\u2013control study. Life 11(6). https:\/\/doi.org\/10.3390\/life11060487","DOI":"10.3390\/life11060487"},{"issue":"5\u20136","key":"6025_CR5","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1177\/08830738241252209","volume":"39","author":"OM Espitia Segura","year":"2024","unstructured":"Espitia Segura OM, Bedoya Morales AM, Ram\u00edrez-Sierra CL, Farf\u00e1n-Albarrac\u00edn JD, P\u00e9rez C\u00e1rdenas SH, S\u00e1nchez Rinc\u00f3n JD, Guzm\u00e1n-Porras JJ, L\u00f3pez Mora LF, Ram\u00edrez Salazar MH, Ceballos Inga LA, Rueda Rodr\u00edguez MC, T\u00e9llez Prada HA, Castro Rubio JC, Lemus Espitia I, Guevara Ramos JD (2024) Headache and other factors modifying cerebrospinal fluid opening pressure in pediatric patients. J Child Neurol 39(5\u20136):195\u2013200. https:\/\/doi.org\/10.1177\/08830738241252209","journal-title":"J Child Neurol"},{"issue":"3","key":"6025_CR6","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1177\/0883073809338874","volume":"25","author":"MJ Lim","year":"2010","unstructured":"Lim MJ, Pushparajah K, Jan W, Calver D, Lin JP (2010) Magnetic resonance imaging changes in idiopathic intracranial hypertension in children. J Child Neurol 25(3):294\u2013299","journal-title":"J Child Neurol"},{"issue":"3","key":"6025_CR7","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1007\/s00381-014-2579-0","volume":"31","author":"SB G\u00f6rkem","year":"2015","unstructured":"G\u00f6rkem SB, Do\u011fanay S, Canpolat M, Koc G, Dogan MS, Per H et al (2015) MR imaging findings in children with pseudotumor cerebri and comparison with healthy controls. Child\u2019s Nerv Syst 31(3):373\u2013380","journal-title":"Child\u2019s Nerv Syst"},{"key":"6025_CR8","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1007\/978-3-319-68536-6_13","volume-title":"Clinical neuroradiology","author":"A Zimny","year":"2019","unstructured":"Zimny A, S\u0105siadek M (2019) Imaging of idiopathic intracranial hypertension. In: Barkhof F, Thurnher MM (eds) Clinical neuroradiology. Springer Nature, pp 545\u2013556"},{"issue":"6","key":"6025_CR9","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1001\/jamaneurol.2021.0710","volume":"78","author":"BS Chen","year":"2021","unstructured":"Chen BS, Meyer BI, Saindane AM, Bruce BB, Newman NJ, Biousse V (2021) Prevalence of Incidentally Detected Signs of Intracranial Hypertension on Magnetic Resonance Imaging and Their Association With Papilledema. JAMA Neurol 78(6):718\u2013725. https:\/\/doi.org\/10.1001\/jamaneurol.2021.0710","journal-title":"JAMA Neurol"},{"key":"6025_CR10","doi-asserted-by":"publisher","first-page":"100371","DOI":"10.1016\/j.ejro.2021.100371","volume":"8","author":"WM Marashdeh","year":"2021","unstructured":"Marashdeh WM, Al Qaralleh MA, Hdeeb AH (2021) Quantitative parameters for diagnosis of idiopathic intracranial hypertension on brain MRI. Eur J Radiol Open [Internet] 8:100371. https:\/\/doi.org\/10.1016\/j.ejro.2021.100371","journal-title":"Eur J Radiol Open [Internet]"},{"key":"6025_CR11","unstructured":"Barkovich JA, Koch BL (2007) Enlarged Subarachnoid Space. In: Barkovich JA, Moore KR, Grant E (eds) Diagnostic imaging: pediatric neuroradiology. 1st edn. Salt Lake City, Utah: Amirsys-Elsevier, pp I:5\u201330\u2013I:5\u201333"},{"issue":"12","key":"6025_CR12","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1177\/08830738211045234","volume":"36","author":"A Kamali","year":"2021","unstructured":"Kamali A, Aein A, Naderi N, Choi SJ, Doyle N, Butler IJ et al (2021) Neuroimaging features of intracranial hypertension in pediatric patients with new-onset idiopathic seizures, a comparison with patients with confirmed diagnosis of idiopathic intracranial hypertension: a preliminary study. J Child Neurol 36(12):1103\u20131110","journal-title":"J Child Neurol"},{"issue":"3","key":"6025_CR13","doi-asserted-by":"publisher","first-page":"471","DOI":"10.3174\/ajnr.A5055","volume":"38","author":"PP Morris","year":"2017","unstructured":"Morris PP, Black DF, Port J, Campeau N (2017) Transverse sinus stenosis is the most sensitive MR imaging correlate of idiopathic intracranial hypertension. Am J Neuroradiol 38(3):471\u2013477","journal-title":"Am J Neuroradiol"},{"issue":"2","key":"6025_CR14","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1080\/02688690500145563","volume":"19","author":"JNP Higgins","year":"2005","unstructured":"Higgins JNP, Tipper G, Varley M, Pickard JD (2005) Transverse sinus stenoses in benign intracranial hypertension demonstrated on CT venography. Br J Neurosurg 19(2):137\u2013140","journal-title":"Br J Neurosurg"},{"key":"6025_CR15","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.pediatrneurol.2022.12.010","volume":"140","author":"A Kamali","year":"2023","unstructured":"Kamali A, Park ES, Lee SA, Nunez LC, Butler IJ, Sitton CW et al (2023) Introducing the \u201ctemporal thumb sign\u201d in pediatric patients with new-onset idiopathic seizures with and without elevated cerebrospinal fluid opening pressure. Pediatr Neurol 140:52\u201358","journal-title":"Pediatr Neurol"},{"issue":"14","key":"6025_CR16","doi-asserted-by":"publisher","first-page":"2302","DOI":"10.1002\/sim.7273","volume":"36","author":"R Puhr","year":"2017","unstructured":"Puhr R, Heinze G, Nold M, Lusa L, Geroldinger A (2017) Firth\u2019s logistic regression with rare events: accurate effect estimates and predictions? Stat Med 36(14):2302\u20132317. https:\/\/doi.org\/10.1002\/sim.7273","journal-title":"Stat Med"},{"key":"6025_CR17","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.pediatrneurol.2016.04.007","volume":"61","author":"SC Aylward","year":"2016","unstructured":"Aylward SC, Waslo CS, Au JN, Tanne E (2016) Manifestations of Pediatric Intracranial Hypertension From the Intracranial Hypertension Registry. Pediatr Neurol 61:76\u201382. https:\/\/doi.org\/10.1016\/j.pediatrneurol.2016.04.007","journal-title":"Pediatr Neurol"},{"issue":"3","key":"6025_CR18","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1007\/s00381-009-1018-0","volume":"26","author":"D Tibussek","year":"2010","unstructured":"Tibussek D, Schneider DT, Vandemeulebroecke N et al (2010) Clinical spectrum of the pseudotumor cerebri complex in children. Childs Nerv Syst 26(3):313\u2013321. https:\/\/doi.org\/10.1007\/s00381-009-1018-0","journal-title":"Childs Nerv Syst"},{"issue":"17_supplement_1","key":"6025_CR19","doi-asserted-by":"publisher","first-page":"6258","DOI":"10.1212\/WNL.0000000000206352","volume":"102","author":"N Arunkumar","year":"2024","unstructured":"Arunkumar N, Nisar A, Sharan I, Chan J, Faro S, Mondel P, Jain N, Talekar K, Chaganti J, Spare N, Gooch R, Yuan H (2024) Inter-rater reliability and standardization on neuroimaging for idiopathic intracranial hypertension (S20.004). Neurology 102(17_supplement_1):6258. https:\/\/doi.org\/10.1212\/WNL.0000000000206352","journal-title":"Neurology"},{"issue":"April","key":"6025_CR20","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.ejrad.2019.04.023","volume":"116","author":"RM Kwee","year":"2019","unstructured":"Kwee RM, Kwee TC (2019) Systematic review and meta-analysis of MRI signs for diagnosis of idiopathic intracranial hypertension. Eur J Radiol [Internet] 116(April):106\u201315. https:\/\/doi.org\/10.1016\/j.ejrad.2019.04.023","journal-title":"Eur J Radiol [Internet]"},{"issue":"22","key":"6025_CR21","doi-asserted-by":"publisher","first-page":"e2714","DOI":"10.1212\/WNL.0000000000012023","volume":"96","author":"L D'Antona","year":"2021","unstructured":"D\u2019Antona L, Asif H, Craven CL, McHugh JA, Vassiliou A, Thorne L, Matharu MS, Watkins LD, Bremner F, Toma AK (2021) Brain MRI and ophthalmic biomarkers of intracranial pressure. Neurology 96(22):e2714\u2013e2723. https:\/\/doi.org\/10.1212\/WNL.0000000000012023","journal-title":"Neurology"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-025-06025-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-025-06025-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-025-06025-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T09:24:12Z","timestamp":1743067452000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-025-06025-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,1]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["6025"],"URL":"https:\/\/doi.org\/10.1007\/s00431-025-06025-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-5364061\/v1","asserted-by":"object"}]},"ISSN":["1432-1076"],"issn-type":[{"value":"1432-1076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,1]]},"assertion":[{"value":"31 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 January 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 January 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 March 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the HOMI Fundaci\u00f3n Hospital Pedi\u00e1trico la Misericordia Ethics Committee (Approval No. 78 584-23R). The authors declare that all procedures followed the ethical standards of the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"218"}}