Sigmoid Sinus Diverticulum, Dehiscence, and Venous Sinus Stenosis: Potential Causes of Pulsatile Tinnitus in Patients with Idiopathic Intracranial Hypertension?

Lansley, Joseph; Tucker, William T.; Eriksen, Marius; Riordan-Eva, Paul; Connor, Steve

doi:10.3174/ajnr.a5277

Cited by 43 publications

(37 citation statements)

References 29 publications

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“…The technique described in this study can be implemented to explore other pathologies such as venous stenosis, often associated with idiopathic intracranial hypertension (IIH) and pulsatile tinnitus. 10…”

Section: Discussionmentioning

confidence: 99%

Pressure Mapping and Hemodynamic Assessment of Intracranial Dural Sinuses and Dural Arteriovenous Fistulas with 4D Flow MRI

Rivera‐Rivera¹,

Johnson

Turski

et al. 2017

AJNR Am J Neuroradiol

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SUMMARY:The feasibility of 4D flow MR imaging to visualize flow patterns and generate relative pressure maps in the dural venous sinus in healthy subjects (n ϭ 60) and patients with dural arteriovenous fistulas (n ϭ 7) was investigated. Dural venous drainage was classified based on torcular Herophili anatomy by using 4D flow MR imaging-derived angiograms and magnitude images. Subjects were scanned in a 3T clinical MR imaging system. 4D flow MR imaging enabled noninvasive characterization of dural sinus anatomy and mapping of relative pressure differences.ABBREVIATIONS: DAVF ϭ dural arteriovenous fistula; TS ϭ transverse sinus

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Section: Discussionmentioning

confidence: 99%

Pressure Mapping and Hemodynamic Assessment of Intracranial Dural Sinuses and Dural Arteriovenous Fistulas with 4D Flow MRI

Rivera‐Rivera¹,

Johnson

Turski

et al. 2017

AJNR Am J Neuroradiol

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“…[13][14][15] Pseudotumor cerebri syndrome (PTCS), also known as idiopathic or benign intracranial hypertension, is characterized by increased intracranial pressure, which may lead to complete loss of vision and disabilities due to intractable headaches or pulsatile tinnitus. [16][17][18][19][20] Dural sinus venous outflow obstruction may be observed in up to 93% of patients with PTCS and plays an important role in the syndrome pathophysiology. 21,22 Transverse sinus stenosis is the most sensitive sign of PTCS on MR imaging.…”

mentioning

confidence: 99%

The Occipital Emissary Vein: A Possible Marker for Pseudotumor Cerebri

Hedjoudje

Piveteau

Gonzalez-Campo

et al. 2019

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Transverse sinus stenosis can lead to pseudotumor cerebri syndrome by elevating the cerebral venous pressure. The occipital emissary vein is an inconstant emissary vein that connects the torcular herophili with the suboccipital veins of the external vertebral plexus. This retrospective study compares the prevalence and size of the occipital emissary vein in patients with pseudotumor cerebri syndrome with those in healthy control subjects to determine whether the occipital emissary vein could represent a marker of pseudotumor cerebri syndrome. MATERIALS AND METHODS: The cranial venous system of 46 adult patients with pseudotumor cerebri syndrome (group 1) was studied on CT venography images and compared with a group of 92 consecutive adult patients without pseudotumor cerebri syndrome who underwent venous assessment with gadolinium-enhanced 3D-T1 MPRAGE sequences (group 2). The presence of an occipital emissary vein was assessed, and its proximal (intraosseous) and distal (extracranial) maximum diameters were measured and compared between the 2 groups. Seventeen patients who underwent transverse sinus stent placement had their occipital emissary vein diameters measured before and after stent placement. RESULTS: Thirty of 46 (65%) patients in group 1 versus 29/92 (31.5%) patients in group 2 had an occipital emissary vein (P Ͻ .001). The average proximal and distal occipital emissary vein maximum diameters were significantly larger in group 1 (2.3 versus 1.6 mm, P Ͻ.005 and 3.3 versus 2.3 mm, P Ͻ .001). The average maximum diameters of the occipital emissary vein for patients who underwent transverse sinus stent placement were larger before stent placement than after stent placement: 2.6 versus 1.8 mm proximally (P Ͻ .06) and 3.7 versus 2.6 mm distally (P Ͻ .005). CONCLUSIONS: Occipital emissary veins are more frequent and larger in patients with pseudotumor cerebri syndrome than in healthy subjects, a finding consistent with their role as collateral venous pathway in transverse sinus stenosis. A prominent occipital emissary vein is an imaging sign that should raise the suspicion of pseudotumor cerebri syndrome. ABBREVIATIONS: OEV ϭ occipital emissary vein; MDCT ϭ multidetector row CT; PTCS ϭ pseudotumor cerebri syndrome; SCTV ϭ subtracted CT venography

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“…33 Sigmoid sinus dehiscence may also be seen in patients with idiopathic intracranial hypertension with or without concomitant stenosis at the transverse-sigmoid sinus junction and the more laterally placed sigmoid sinus. 34 Recently, transmastoid repair for sigmoid sinus dehiscence has been described. This comprises a cortical mastoidectomy, which is further extended to the lateral wall of the sigmoid sinus.…”

Section: Jugular Bulb and Sigmoid Sinus Dehiscence Repairsmentioning

confidence: 99%

Beyond Tympanomastoidectomy: A Review of Less Common Postoperative Temporal Bone CT Findings

Carlson

Diehn²,

Lane³

2020

AJNR Am J Neuroradiol

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Sigmoid Sinus Diverticulum, Dehiscence, and Venous Sinus Stenosis: Potential Causes of Pulsatile Tinnitus in Patients with Idiopathic Intracranial Hypertension?

Cited by 43 publications

References 29 publications

Pressure Mapping and Hemodynamic Assessment of Intracranial Dural Sinuses and Dural Arteriovenous Fistulas with 4D Flow MRI

Pressure Mapping and Hemodynamic Assessment of Intracranial Dural Sinuses and Dural Arteriovenous Fistulas with 4D Flow MRI

The Occipital Emissary Vein: A Possible Marker for Pseudotumor Cerebri

Beyond Tympanomastoidectomy: A Review of Less Common Postoperative Temporal Bone CT Findings

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