Association of spontaneous cerebrospinal fluid rhinorrhea with transverse venous sinus stenosis: a retrospective matched case‐control study

Abstract

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.

Association of spontaneous cerebrospinal fluid rhinorrhea with transverse venous sinus stenosis: a retrospective matched case‐control study

“…In their study, Bedarida et al found higher rates of TSS in the patient group with sCSF rhinorrhea ( p < 0.001). They interpreted that their results and those of a previous study favor the association between sCSF leaks and idiopathic intracranial hypertension (IIH) 1 . Moreover, they proposed that the main pathophysiologic hypothesis of sCSF leaks may be explained as being secondary to IIH 1 .…”

“…Association of spontaneous cerebrospinal fluid rhinorrhea with transverse venous sinus stenosis a retrospective matched case-control study I read with great interest the article by Bedarida et al, 1 in which they investigated the presence of transverse venous sinus stenosis (TSS) in the patient group undergoing endoscopic surgery for spontaneous cerebrospinal fluid (sCSF) rhinorrhea. I sincerely thank the authors for conducting such original research and including a considerable number of patients.…”

“…They interpreted that their results and those of a previous study favor the association between sCSF leaks and idiopathic intracranial hypertension (IIH). 1 Moreover, they proposed that the main pathophysiologic hypothesis of sCSF leaks may be explained as being secondary to IIH. 1 In contrast, they observed a low rate of papilledema and elevated CSF pressure in the patient group and stated that these findings were in accordance with previously reported results.…”

“…1 Moreover, they proposed that the main pathophysiologic hypothesis of sCSF leaks may be explained as being secondary to IIH. 1 In contrast, they observed a low rate of papilledema and elevated CSF pressure in the patient group and stated that these findings were in accordance with previously reported results. 2 Notably, systematic fundoscopic measurement or CSF pressure measurement was not performed for any of the patients.…”

Reply to: Correspondence ‐ Association of spontaneous cerebrospinal fluid rhinorrhea with transverse venous sinus stenosis: a retrospective matched case‐control study

“…We have read with great interest Dr Onder's correspondence 1 regarding our article 2 . In our study, we reported a higher incidence of transverse venous sinus stenosis (TSS) in a group of patients operated on for a spontaneous cerebrospinal fluid (sCSF) leak than in a control group of patients adjusted for age and sex.…”