Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis

Neurology. 2003 May 13;60(9):1418-24. doi: 10.1212/01.wnl.0000066683.34093.e2.


Objective: To determine the prevalence and nature of sinovenous obstruction in idiopathic intracranial hypertension (IIH) using auto-triggered elliptic-centric-ordered three-dimensional gadolinium-enhanced MR venography (ATECO MRV).

Methods: In a prospective controlled study, 29 patients with established IIH as well as 59 control patients underwent ATECO MRV. In a randomized blinded fashion, three readers evaluated the images. Using a novel scoring system, each reader graded the degree of stenosis seen in the transverse and sigmoid sinuses of each patient.

Results: There was excellent agreement across the three readers for application of the grading system. Substantial bilateral sinovenous stenoses were seen in 27 of 29 patients with IIH and in only 4 of 59 control patients.

Conclusion: Using ATECO MRV and a novel grading system for quantifying sinovenous stenoses, the authors can identify IIH patients with sensitivity and specificity of 93%.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cavernous Sinus / diagnostic imaging
  • Cavernous Sinus / pathology*
  • Cerebral Veins / diagnostic imaging
  • Cerebral Veins / pathology*
  • Constriction, Pathologic / diagnostic imaging
  • Female
  • Humans
  • Intracranial Hypertension / diagnostic imaging
  • Intracranial Hypertension / epidemiology
  • Intracranial Hypertension / etiology*
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Radiography
  • Single-Blind Method