{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:59:50Z","timestamp":1787169590433,"version":"build-2736575974"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study investigated the prevalence and association of magnetic resonance imaging (MRI) imaging markers indicative of idiopathic intracranial hypertension (IIH) in patients diagnosed with endolymphatic hydrops (EH). The objective was to elucidate potential pathophysiological links between inner ear fluid dysregulation and alterations in intracranial pressure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 108 adult patients with dedicated MRI and delayed post-contrast (hydrops) sequences obtained for assessment of auditory\/vestibular symptoms between 01\/2020 and 06\/2025 were retrospectively reviewed. EH grading, nerve volumes of the cochlear nerve, common vestibular trunk and facial nerve, IIH imaging features (e.g., Meckel\u2019s cave dilatation, optic nerve findings, venous sinus stenosis), and clinical symptoms were recorded. The prevalence and co-occurrence of EH and IIH features were statistically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Vestibular EH (grade 2) was noted in 71.3% (right) and 60.2% (left) of patients and cochlear EH (grade 2) in 42.6% (left) and 34.3% (right) of patients. IIH-related imaging markers were common: bilateral Meckel\u2019s cave dilatation (60.2%), partially empty sella turcica (50.9%), bilateral optic nerve sheath dilation (57.4%), optic nerve head enhancement on delayed FLAIR sequences (67.6%), and intrinsic bilateral transverse sinus stenosis (26.9%). Statistically significant associations were identified between vestibular EH severity and optic nerve sheath dilation (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0368), optic nerve tortuosity (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0309), slit-like lateral ventricles (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0023), and increased subcutaneous fat thickness in the scalp and neck (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003). Conversely, intrinsic bilateral transverse sinus stenosis was negatively correlated with EH severity (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u202f=\u202f\u22120.228,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.017). Overlap analyses demonstrated that many patients with moderate to severe EH exhibited multiple IIH imaging features concomitantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MRI findings demonstrate a frequent coexistence of EH and radiological biomarkers of IIH. This observation supports a potential pathophysiological association between inner ear fluid dysregulation and elevated intracranial pressure, underscoring the need for prospective studies integrating clinical outcomes with advanced MRI-based assessments of fluid dynamics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1751689","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T06:45:08Z","timestamp":1766040308000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Endolymphatic hydrops and intracranial hypertension: a quantitative MRI analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Anne R. J.","family":"P\u00e9port\u00e9","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Kostova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jatta","family":"Berberat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustav","family":"Andreisek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Sch\u00f6n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franca","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e539","DOI":"10.1097\/MAO.0000000000001479","article-title":"Meni\u00e8re and friends: imaging and classification of hydropic ear disease","volume":"38","author":"G\u00fcrkov","year":"2017","journal-title":"Otol Neurotol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1525954","DOI":"10.3389\/fneur.2024.1525954","article-title":"Secondary endolymphatic hydrops: a clinical and literature overview","volume":"15","author":"Venkatasamy","year":"2024","journal-title":"Front Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"874971","DOI":"10.3389\/fsurg.2022.874971","article-title":"Consensus on MR imaging of endolymphatic hydrops in patients with suspected hydropic ear disease (Meniere)","volume":"9","author":"Liu","year":"2022","journal-title":"Front Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1007\/s11604-014-0290-4","article-title":"Visualization of endolymphatic hydrops with MR imaging in patients with M\u00e9ni\u00e8re\u2019s disease and related pathologies: current status of its methods and clinical significance","volume":"32","author":"Naganawa","year":"2014","journal-title":"Jpn J Radiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1097\/MLG.0b013e31802c300c","article-title":"Visualization of endolymphatic hydrops in patients with Meniere\u2019s disease","volume":"117","author":"Nakashima","year":"2007","journal-title":"Laryngoscope"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.anl.2020.10.009","article-title":"Diagnostic and therapeutic strategies for Meniere\u2019s disease of the Japan Society for Equilibrium Research","volume":"48","author":"Iwasaki","year":"2021","journal-title":"Auris Nasus Larynx"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1212\/01.wnl.0000333254.84120.f5","article-title":"Idiopathic intracranial hypertension in men","volume":"72","author":"Bruce","year":"2009","journal-title":"Neurology"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1827","DOI":"10.1212\/WNL.0b013e3181e0f838","article-title":"Atypical idiopathic intracranial hypertension: normal BMI and older patients","volume":"74","author":"Bruce","year":"2010","journal-title":"Neurology"},{"key":"ref9","first-page":"155","article-title":"Idiopathic intracranial hypertension. A prospective study of 50 patients","volume":"114","author":"Wall","year":"1991","journal-title":"Brain"},{"key":"ref10","first-page":"258","article-title":"Otologic manifestations of pseudotumor cerebri","volume":"20","author":"Murphy","year":"1991","journal-title":"J Otolaryngol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1288\/00005537-198708001-00001","article-title":"Otologic manifestations of benign intracranial hypertension syndrome: diagnosis and management","volume":"97","author":"Sismanis","year":"1987","journal-title":"Laryngoscope"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1288\/00005537-199001000-00008","article-title":"Objective tinnitus in benign intracranial hypertension: an update","volume":"100","author":"Sismanis","year":"1990","journal-title":"Laryngoscope"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1007\/s00405-009-0973-0","article-title":"Idiopathic intracranial hypertension in otolaryngology","volume":"266","author":"Jindal","year":"2009","journal-title":"Eur Arch Otorrinolaringol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"303","DOI":"10.3233\/VES-200790","article-title":"The neurologist and the hydrops","volume":"31","author":"Redon","year":"2021","journal-title":"J Vestib Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"NP329","DOI":"10.1177\/0145561320969448","article-title":"Comparative study between the auditory and vestibular functions in M\u00e9ni\u00e8re\u2019s disease","volume":"101","author":"Maihoub","year":"2022","journal-title":"Ear Nose Throat J"},{"key":"ref16","first-page":"1099","article-title":"Anatomy of the facial and vestibulocochlear nerves in the internal auditory canal","volume":"17","author":"Rubinstein","year":"1996","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1016\/S1064-968(02)00008-9","article-title":"Imaging of the lower cranial nerves","volume":"10","author":"Laine","year":"2002","journal-title":"Magn Reson Imaging Clin N Am"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/s00234-019-02155-7","article-title":"The value of four stage vestibular hydrops grading and asymmetric perilymphaticenhancement in the diagnosis of Meni\u00e8re\u2019s disease on MRI","volume":"61","author":"Bernaerts","year":"2019","journal-title":"Neuroradiology"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1177\/0333102413484095","article-title":"Morphometric and volumetric MRI changes in idiopathic intracranial hypertension","volume":"33","author":"Hoffmann","year":"2013","journal-title":"Cephalalgia"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1002\/1522-2586(200012)12:6<808::aid-jmri3>3.0.co;2-n","article-title":"MR imaging of pituitary morphology in idiopathic intracranial hypertension","volume":"12","author":"Yuh","year":"2000","journal-title":"J Magn Reson Imaging"},{"key":"ref21","first-page":"551","article-title":"MR height of the pituitary gland as a function of age and sex: especially physiological hypertrophy in adolescence and in climacterium","volume":"18","author":"Tsunoda","year":"1997","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.2214\/AJR.12.9013","article-title":"Factors determining the clinical significance of an \u201cempty\u201d sella turcica","volume":"200","author":"Saindane","year":"2013","journal-title":"AJR Am J Roentgenol"},{"key":"ref23","first-page":"261","article-title":"Pituitary height on magnetic resonance imaging observation of age and sex related changes","volume":"58","author":"Ikram","year":"2008","journal-title":"J Pak Med Assoc"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"3009","DOI":"10.1210\/jcem.86.7.7649","article-title":"Normal pituitary hypertrophy as a frequent cause of pituitary incidentaloma: a follow-up study","volume":"86","author":"Chanson","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"608","DOI":"10.2214\/AJR.13.10874","article-title":"Meningoceles in idiopathic intracranial hypertension","volume":"202","author":"Bialer","year":"2014","journal-title":"AJR Am J Roentgenol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"W457","DOI":"10.2214\/AJR.14.12787","article-title":"Enlarged CSF spaces in pseudotumor cerebri","volume":"203","author":"San Mill\u00e1n","year":"2014","journal-title":"AJR Am J Roentgenol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.3174\/ajnr.A6682","article-title":"Indentation and transverse diameter of the Meckel cave: imaging markers to diagnose idiopathic intracranial hypertension","volume":"41","author":"Kamali","year":"2020","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref28","first-page":"666","article-title":"Defining optic nerve tortuosity","volume":"28","author":"Armstrong","year":"2007","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"R114","DOI":"10.1186\/cc7006","article-title":"Use of T2-weighted magnetic resonance imaging of the optic nerve sheath to detect raised intracranial pressure","volume":"12","author":"Geeraerts","year":"2008","journal-title":"Crit Care"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.1016\/j.ajem.2013.07.028","article-title":"Correlation of optic nerve sheath diameter measurements by computed tomography and magnetic resonance imaging","volume":"31","author":"Kalantari","year":"2013","journal-title":"Am J Emerg Med"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"863","DOI":"10.3174\/ajnr.A1027","article-title":"Decreased diameter of the optic nerve sheath associated with CSF hypovolemia","volume":"29","author":"Watanabe","year":"2008","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"366","DOI":"10.3174\/ajnr.A2779","article-title":"Optic nerve sheath diameter on MR imaging: establishment of norms and comparison of pediatric patients with idiopathic intracranial hypertension with healthy controls","volume":"33","author":"Shofty","year":"2012","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1186\/1471-2377-13-187","article-title":"Reproducibility and accuracy of optic nerve sheath diameter assessment using ultrasound compared to magnetic resonance imaging","volume":"13","author":"Bauerle","year":"2013","journal-title":"BMC Neurol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1016\/j.crad.2011.12.002","article-title":"Accuracy of brain imaging in the diagnosis of idiopathic intracranial hypertension","volume":"67","author":"Maralani","year":"2012","journal-title":"Clin Radiol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1007\/s00234-006-0095-y","article-title":"Idiopathic intracranial hypertension: the validity of cross-sectional neuroimaging signs","volume":"48","author":"Agid","year":"2006","journal-title":"Neuroradiology"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1177\/0194599817699401","article-title":"Radiographic evidence of occult intracranial hypertension in patients with M\u00e9ni\u00e8re\u2019s disease","volume":"157","author":"Tawfik","year":"2017","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"334","DOI":"10.3174\/ajnr.A5937","article-title":"Contrast-enhanced 3D-FLAIR imaging of the optic nerve and optic nerve head: novel neuroimaging findings of idiopathic intracranial hypertension","volume":"40","author":"Golden","year":"2019","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1212\/WNL.0b013e31827debd6","article-title":"Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis","volume":"80","author":"Riggeal","year":"2013","journal-title":"Neurology"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.ijscr.2017.07.039","article-title":"Chiari I malformation with underlying pseudotumor cerebri: poor symptom relief following posterior decompression surgery","volume":"38","author":"Alnemari","year":"2017","journal-title":"Int J Surg Case Rep"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"3331024231161323","DOI":"10.1177\/03331024231161323","article-title":"\u201cIdiopathic\u201d intracranial hypertension: an update from neurointerventional research for clinicians","volume":"43","author":"Fargen","year":"2023","journal-title":"Cephalalgia"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"5173","DOI":"10.1007\/s00405-022-07366-y","article-title":"Depression scores and quality of life of vertiginous patients, suffering from different vestibular disorders","volume":"279","author":"Moln\u00e1r","year":"2022","journal-title":"Eur Arch Otorrinolaringol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"e860","DOI":"10.1097\/MAO.0000000000002665","article-title":"Spontaneous intracranial hypotension may be an under-recognized cause of endolymphatic hydrops","volume":"41","author":"Sakano","year":"2020","journal-title":"Otol Neurotol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1812","DOI":"10.1111\/head.13866","article-title":"Endolymphatic hydrops secondary to spontaneous intracranial hypotension","volume":"60","author":"Poillon","year":"2020","journal-title":"Headache"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1394534","DOI":"10.3389\/fneur.2024.1394534","article-title":"A hidden pathophysiology of endolymphatic hydrops: case report of a patient with spontaneous intracranial hypotension presenting with sudden sensorineural hearing loss with vertigo","volume":"15","author":"Kim","year":"2024","journal-title":"Front Neurol"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1177\/000348940211100910","article-title":"Spontaneous intracranial hypotension: a rare cause of labyrinthine hydrops","volume":"111","author":"Portier","year":"2002","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s10072-017-2895-8","article-title":"Endolymphatic hydrops in idiopathic intracranial hypertension: prevalence and clinical outcome after lumbar puncture. Preliminary data","volume":"38","author":"Ranieri","year":"2017","journal-title":"Neurol Sci"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"2661","DOI":"10.1007\/s00405-013-2751-2","article-title":"Endolymphatic hydrops in patients with vestibular migraine and auditory symptoms","volume":"271","author":"G\u00fcrkov","year":"2014","journal-title":"Eur Arch Otorrinolaringol"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/s00405-024-08895-4","article-title":"Magnetic resonance imaging evaluation of cochlear and vestibular nerve calibre: a case-control study in M\u00e9ni\u00e8re\u2019s disease and endolymphatic hydrops","volume":"282","author":"Khalifa","year":"2025","journal-title":"Eur Arch Otorrinolaringol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1751689\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T06:45:10Z","timestamp":1766040310000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1751689\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,18]]},"references-count":48,"alternative-id":["10.3389\/fneur.2025.1751689"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1751689","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,18]]},"article-number":"1751689"}}