Reversible transverse sinus collapse in a patient with idiopathic intracranial hypertension

BMJ Case Rep. 2015 May 15;2015:bcr2014011606. doi: 10.1136/bcr-2014-011606.

Abstract

The association of idiopathic intracranial hypertension (IIH) with stenosis or narrowing of the transverse sinuses (TSs) is well known. However, there is debate as to whether the stenosis is a cause or consequence. Here we describe a case of IIH and narrowing of the TSs, with four relapses and recoveries after repeated CSF diversions with lumbar puncture (LP) over 2 months. Subsequently, implantation of a lumboperitoneal shunt (LPrS) ensured recovery. MR venography 20 months after LPrS showed normally calibrated TSs. We show repeated MR venography findings before and after the LPs, and discuss the pathogenesis of IIH in terms of the cause and effect relationship between IIH and sinus collapse.

Keywords: Intracranial Pressure; Magnetic Resonance Angiography; Stenosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cerebrovascular Disorders / complications*
  • Cerebrovascular Disorders / diagnostic imaging
  • Cerebrovascular Disorders / pathology
  • Cerebrovascular Disorders / therapy
  • Constriction, Pathologic / complications
  • Dura Mater / diagnostic imaging
  • Dura Mater / pathology*
  • Humans
  • Intracranial Hypertension / complications*
  • Intracranial Hypertension / diagnostic imaging
  • Intracranial Hypertension / pathology
  • Intracranial Hypertension / therapy
  • Magnetic Resonance Angiography
  • Male
  • Phlebography
  • Spinal Puncture
  • Transverse Sinuses / diagnostic imaging
  • Transverse Sinuses / pathology*