 respectable sir and madam myself the author Dr. Apurva Prasanna Jacta is presenting a paper on MRI evaluation of idiopathic intravenial hypertension in patients with complaints of headache with the co-authors that are Dr. Pramod Shah, Dr. Amol Gautam and Dr. Dinesh Pottar from the Institute that is Krishna Institute of Medical Sciences Karad Maharashtra presenting a paper in CTBUS 2021. The aims and objective of this study is to aid the diagnosis of idiopathic intravenial hypertension in particularly those patients who present with complaints of headache and who are not a known case of any other intravenial pathology and once the idiopathic intravenial hypertension is identified to describe the spectrum that is seen in these patients on MRI brain study. This study was a retrospective observational type of study in a group of 30 patients who had presented to the department of radio diagnosis in Krishna Institute of Medical Sciences Karad with primary complaints of headaches. The patients were evaluated for presence or absence of the various traditional signs of intravenial idiopathic hypertension which are empty cellar, flattening of the posterior surface of the globes, the optic nerve head protrusion, distention of the optic nerve sheets, tortuosity of the optic nerve, cerebellar tonsillar herniation, tight subarachnoid spaces and slit-like ventricles. The study was conducted over a period of six months. In the study group of 30 patients that had presented in the department with complaints of headache and those were included in the studies, 18 were female patients that was about 60 percent while 12 were males that is about 40 percent. The age group of these patients ranged from 16 to 48 years and the mean age was about 27 years. Three patients were in the age group of 15 to 20 years. Eight patients were in the group of 20 to 30 years while nine patients were in the group of 30 to 40 years while the remaining 11 patients were in amongst the group of 40 to 50 years of age. The various MRI findings that were seen in the study group were empty cellar was the first and the highest finding on the MR brain in patients presenting with complaints of headache which was seen in about 70 percent of cases that is about 21 patients. The second most common MR finding was perioptic nerve sheath distinction which was seen in 50 percent of cases followed by posterior globe flattening which was seen in 13 patients then the tortuosity of the optic nerve seen in 12 patients coming about 40 percent cases followed by intracranial intraocular bulge of the optic nerve which was seen in the 10 percent of cases that is three patients and the other findings were seen in the rest of the patients like minimally like a slit like ventricles and tight subarachnoid spaces. The first image is about an MRI axial T2 weighted image in of a 21 year old female patient with complaints of headache in which we can identify that there is a horizontal tortuosity of the optic nerve that has seen that is noted here. Clinically the patient has had presented to the department with complaints of headache, vision changes and papilloidema was noted on examination. While on right are the MR axial as well as coronal T2 weighted brain images in which we can see that both the optic nerves sheath is a distended and show CSF fluid signal intensity. On the second image that is the coronal MR T2 weighted image also we can clearly identify the optic nerve sheath distension this was in the case of a 27 year old woman who had presented with complaints of headache. On the right is of a 31 year old female patient who had presented with complaints of headache on the T2 weighted sagittal image we can see that the cell is completely empty which is a which is a pathognomic sign for the empty cell which is the most common MRI findings seen in patients with idiopathic intracranial hypertension. And the images on the right are are the sequential images seen on various patients. The first image is showing that there is dilated and tortuous course of the optic nerve. The second image is suggestive of the globe flattening. The third image is showing us partially empty cellar. The fourth image that is a D is showing us dilatation and tortuosity of the optic nerve. On the fifth image that is E we can see that there are the CSF filled or distension of the optic nerve sheath with CSF which is same can be confirmed on the coronal T2 image that is seen as the last image. These are the various spectrum of findings which are characteristically seen in condition of idiopathic intracranial hypertension. Idiopathic intracranial hypertension which is also known as pseudo tumor cerebrae and benign intracranial hypertension is a well-established entity and is often a diagnosis of exclusion. We have to differentiate between idiopathic and secondary causes of idiopathic intracranial hypertension. Severe form may lead to various clinical presentations and may also present by nerve sheath distinction. Historically the primary role of imaging in the diagnosis of idiopathic intracranial hypertension has been to exclude other conditions that were resulting in a raised intracranial pressure and papilloidema. Direct transmission of the elevated CSF pressure results in the distension of the perioptic subarachnoid space and ballooning of the optic papilla causing it to protrude physically into the posterior aspect of the globe. The patient exhibited a flattening of the posterior sclera distension of the perioptic subarachnoid space. Idiopathic intracranial hypertension which is also known as the pseudo tumor cerebrae and benign intracranial hypertension. It is a well-established entity and is a diagnosis of exclusion after made after differentiation between the idiopathic and the secondary causes of the same. The severe idiopathic intracranial hypertension which can be leads to optic nerve dilatation and this can be prevented by optic nerve sheath fenestration if the diagnosis is made earlier on. Historically the primary role of imaging in the diagnosis of IIH has been to exclude the other causes that can cause increased intracranial pressure and papilloidema. Direct transmission of elevated CSF pressure resulting in the distension of the perioptic subarachnoid space and ballooning of the optic papilla causing it to protrude physically into the posterior aspect of the globe. The patient's exhibited flattening of the posterior sclera as one of the MR features. Distention of the perioptic subarachnoid space, vertical tortuosity of the optic nerve and empty cell on initial MR images from which a diagnosis of IIH was strongly suspected. Patients who were clinically associated with papilloma and suspected for idiopathic intracranial hypertension of the exclusion of the other etiologies was made. If IIH is clinically suspected, patients should be imaged with use of MR brain evaluation in order to rule out the secondary causes of increased intracranial hypertension and once that is made we can assess the signs which may be frequently incidentally found that is the flattening of the posterior groups, increased of the optic nerve sheath width, empty cell, increased tortuosity and enhancement of the optic nerve and intraocular protrusion of the optic nerve head. Furthermore, once the diagnosis is made, evaluation of the CNS circulation including the intracranial sinuses is also important in order to identify the etiology of the idiopathic intracranial hypertension.