Functional stroke mimics are an important subgroup admitted to acute stroke services and have a distinct demographic and clinical profile. Their outcomes are poorly monitored. Services should be developed to better diagnose and manage these patients.

Background A significant proportion of spontaneous cerebrospinal fluid sCSF leaks are associated with idiopathic intracranial hypertension IIH The aim of this study was to assess the association between sCSF rhinorrhea and transverse venous sinus stenosis VSS a feature commonly observed in IIH with a proposed role in its pathophysiology Methods In this single-center retrospective matched case-control study venous and pituitary imaging data of consecutive patients undergoing endoscopic surgery for sCSF rhinorrhea over the last years were retrospectively reviewed Measurement of the height of the pituitary gland was used to assess empty sella and VSS was quantified as the ratio between the minimal area of the transverse sinus and the cross-sectional area of the sigmoid sinus VSS was considered significant when it was ≥ and bilateral Cases were compared with age-and sex-adjusted controls explored for causes other than IIH intracranial mass effect or venous thrombosis Results Twenty-nine patients were included median age years females body mass index BMI kg/m Cases had a significantly lower height of the pituitary gland than controls mm vs mm p < Bilateral VSS was found in of cases confidence interval CI to vs of controls CI to with p < Conclusion In this retrospective study sCSF leaks were strongly associated with VSS This novel finding provides a rationale for further investigation of the role of VSS in the onset of sCSF leaks and of the potential interest in venous stenting a er the surgical repair of leaks © 2020 ARS-AAOA, LLC.

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