Optic disc swelling: pain on left. Brain MRI: There is a partially empty sella. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma appears unremarkable. The cavernous sinuses are not enlarged. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Orbits MRI: There is prominence of the subarachnoid spaces within the optic nerve sheaths bilaterally. There is also bulging of the left optic nerve disc. The lacrimal glands, extraocular muscles, and periorbital soft tissues are unremarkable. There is no evidence of abnormal intraorbital enhancement or mass lesions.Brain MRV: There is constriction of the bilateral transverse sinuses. There is otherwise no evidence of cerebral venous sinus thrombosis.
The combination of a partially empty sella, constriction of the bilateral transverse sinuses, and prominence of the subarachnoid spaces within the optic nerve sheaths bilaterally with bulging of the left optic nerve disc is suggestive of pseudotumor cerebri. 