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Erschienen in: Neuroradiology 1/2012

01.01.2012 | Diagnostic Neuroradiology

The entire dural sinus tree is compressed in patients with idiopathic intracranial hypertension: a longitudinal, volumetric magnetic resonance imaging study

verfasst von: Axel Rohr, Jan Bindeballe, Christian Riedel, Andreas van Baalen, Thorsten Bartsch, Lutz Doerner, Olav Jansen

Erschienen in: Neuroradiology | Ausgabe 1/2012

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Abstract

Introduction

The objective of this study was to explore the volumetric alterations of dural sinuses in patients with idiopathic intracranial hypertension (IIH).

Methods

Standardized cranial magnetic resonance imaging (MRI) was used in 17 patients prior to and following treatment of IIH and in seven controls. Magnetic resonance venographies (MRV) were employed for (a) judgement of circumscript dural sinus stenoses and (b) computation of sinus volumes. Cross-sectional areas (CSA) of the superior sagittal sinuses (SSS) were measured on T2-weighted images. Results of the initial MRIs were compared to those on follow-up MRIs and to results of controls.

Results

Stenoses of the transverse sinuses (TS) resulting in cranial venous outflow obstruction (CVOO) were present in 15/17 (88%) patients, normalizing in 7/15 cases (47%) after treatment of IIH. CVOO was not detected in the control group. Segmentation of MRV revealed decreased dural sinus volumes in patients with IIH as compared to controls (P = 0.018). Sinus volumes increased significantly with normalization of intracranial pressure independent from disappearing of TS stenoses (P = 0.007). The CSA of the SSS were normal on the initial MRIs of patients with IIH and increased on follow-up after treatment (P < 0.001). However, volumetries displayed overlap in patients and controls.

Conclusions

Patients with IIH not only exhibit bilateral stenoses of the TS as has been reported, but volume changes of their entire dural sinus system also occur. The potential etiopathological and diagnostic roles of these changes are discussed.
Literatur
1.
Zurück zum Zitat Monro A (1823) Observations on the structure and function of the nervous system. Creech & Johnson, Edinburgh Monro A (1823) Observations on the structure and function of the nervous system. Creech & Johnson, Edinburgh
2.
Zurück zum Zitat Kellie G (1824) Appearances observed in the dissection of two individuals; death from cold and congestion of the brain. Trans Med Chir Soc Edinb 1:84–169 Kellie G (1824) Appearances observed in the dissection of two individuals; death from cold and congestion of the brain. Trans Med Chir Soc Edinb 1:84–169
3.
4.
Zurück zum Zitat Bershad EM, Humphreis WE, Suarez JI (2008) Intracranial hypertension. Semin Neurol 28:690–702PubMedCrossRef Bershad EM, Humphreis WE, Suarez JI (2008) Intracranial hypertension. Semin Neurol 28:690–702PubMedCrossRef
5.
Zurück zum Zitat Binder DK, Horton JC, Lawton MT et al (2004) Idiopathic intracranial hypertension. Neurosurgery 54:538–551, discussion 551–532PubMedCrossRef Binder DK, Horton JC, Lawton MT et al (2004) Idiopathic intracranial hypertension. Neurosurgery 54:538–551, discussion 551–532PubMedCrossRef
6.
Zurück zum Zitat Skau M, Brennum J, Gjerris F et al (2006) What is new about idiopathic intracranial hypertension? An updated review of mechanism and treatment. Cephalalgia 26:384–399PubMedCrossRef Skau M, Brennum J, Gjerris F et al (2006) What is new about idiopathic intracranial hypertension? An updated review of mechanism and treatment. Cephalalgia 26:384–399PubMedCrossRef
7.
Zurück zum Zitat Karahalios DG, Rekate HL, Khayata MH et al (1996) Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology 46:198–202PubMed Karahalios DG, Rekate HL, Khayata MH et al (1996) Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology 46:198–202PubMed
8.
Zurück zum Zitat King JO, Mitchell PJ, Thomson KR et al (2002) Manometry combined with cervical puncture in idiopathic intracranial hypertension. Neurology 58:26–30PubMed King JO, Mitchell PJ, Thomson KR et al (2002) Manometry combined with cervical puncture in idiopathic intracranial hypertension. Neurology 58:26–30PubMed
9.
Zurück zum Zitat Farb RI, Vanek I, Scott JN et al (2003) Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis. Neurology 60:1418–1424PubMed Farb RI, Vanek I, Scott JN et al (2003) Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis. Neurology 60:1418–1424PubMed
10.
Zurück zum Zitat Baryshnik DB, Farb RI (2004) Changes in the appearance of venous sinuses after treatment of disordered intracranial pressure. Neurology 62:1445–1446PubMed Baryshnik DB, Farb RI (2004) Changes in the appearance of venous sinuses after treatment of disordered intracranial pressure. Neurology 62:1445–1446PubMed
11.
Zurück zum Zitat Higgins JN, Pickard JD (2004) Lateral sinus stenoses in idiopathic intracranial hypertension resolving after CSF diversion. Neurology 62:1907–1908PubMed Higgins JN, Pickard JD (2004) Lateral sinus stenoses in idiopathic intracranial hypertension resolving after CSF diversion. Neurology 62:1907–1908PubMed
12.
Zurück zum Zitat McGonigal A, Bone I, Teasdale E (2004) Resolution of transverse sinus stenosis in idiopathic intracranial hypertension after L-P shunt. Neurology 62:514–515PubMed McGonigal A, Bone I, Teasdale E (2004) Resolution of transverse sinus stenosis in idiopathic intracranial hypertension after L-P shunt. Neurology 62:514–515PubMed
13.
Zurück zum Zitat Rohr A, Dorner L, Stingele R et al (2007) Reversibility of venous sinus obstruction in idiopathic intracranial hypertension. AJNR Am J Neuroradiol 28:656–659PubMed Rohr A, Dorner L, Stingele R et al (2007) Reversibility of venous sinus obstruction in idiopathic intracranial hypertension. AJNR Am J Neuroradiol 28:656–659PubMed
14.
Zurück zum Zitat Owler BK, Parker G, Halmagyi GM et al (2003) Pseudotumor cerebri syndrome: venous sinus obstruction and its treatment with stent placement. J Neurosurg 98:1045–1055PubMedCrossRef Owler BK, Parker G, Halmagyi GM et al (2003) Pseudotumor cerebri syndrome: venous sinus obstruction and its treatment with stent placement. J Neurosurg 98:1045–1055PubMedCrossRef
15.
Zurück zum Zitat Higgins JN, Cousins C, Owler BK et al (2003) Idiopathic intracranial hypertension: 12 cases treated by venous sinus stenting. J Neurol Neurosurg Psychiatry 74:1662–1666PubMedCrossRef Higgins JN, Cousins C, Owler BK et al (2003) Idiopathic intracranial hypertension: 12 cases treated by venous sinus stenting. J Neurol Neurosurg Psychiatry 74:1662–1666PubMedCrossRef
16.
Zurück zum Zitat Donnet A, Metellus P, Levrier O et al (2008) Endovascular treatment of idiopathic intracranial hypertension: clinical and radiologic outcome of 10 consecutive patients. Neurology 70:641–647PubMedCrossRef Donnet A, Metellus P, Levrier O et al (2008) Endovascular treatment of idiopathic intracranial hypertension: clinical and radiologic outcome of 10 consecutive patients. Neurology 70:641–647PubMedCrossRef
17.
Zurück zum Zitat De Simone E, Marano C, Fiorillo F et al (2005) Sudden re-opening of collapsed transverse sinuses and longstanding clinical remission after a single lumbar puncture in a case of idiopathic intracranial hypertension pathogenetic implications. Neurol Sci 25:342–344PubMedCrossRef De Simone E, Marano C, Fiorillo F et al (2005) Sudden re-opening of collapsed transverse sinuses and longstanding clinical remission after a single lumbar puncture in a case of idiopathic intracranial hypertension pathogenetic implications. Neurol Sci 25:342–344PubMedCrossRef
18.
Zurück zum Zitat Bateman GA, Stevens SA, Stimpson J (2009) A mathematical model of idiopathic intracranial hypertension incorporating increased arterial inflow and variable venous outflow collapsibility. J Neurosurg 110:446–456PubMedCrossRef Bateman GA, Stevens SA, Stimpson J (2009) A mathematical model of idiopathic intracranial hypertension incorporating increased arterial inflow and variable venous outflow collapsibility. J Neurosurg 110:446–456PubMedCrossRef
19.
Zurück zum Zitat Batemen GA (2008) Stenoses in idiopathic intracranial hypertension: to stent or not to stent? AJNR Am J Neuroradiol 29(2):215; author reply 215–6. Comment on Rohr A, Dorner L, Stingele R et al (2007) Reversibility of venous sinus obstruction in idiopathic intracranial hypertension. AJNR Am J Neuroradiol 28:656–659 Batemen GA (2008) Stenoses in idiopathic intracranial hypertension: to stent or not to stent? AJNR Am J Neuroradiol 29(2):215; author reply 215–6. Comment on Rohr A, Dorner L, Stingele R et al (2007) Reversibility of venous sinus obstruction in idiopathic intracranial hypertension. AJNR Am J Neuroradiol 28:656–659
20.
Zurück zum Zitat De Simone R, Ranieri A, Bonavita V (2010) Advancement in idiopathic intracranial hypertension pathogenesis: focus on sinus venous stenosis. Neurol Sci 31(Suppl 1):S33–9PubMedCrossRef De Simone R, Ranieri A, Bonavita V (2010) Advancement in idiopathic intracranial hypertension pathogenesis: focus on sinus venous stenosis. Neurol Sci 31(Suppl 1):S33–9PubMedCrossRef
21.
Zurück zum Zitat Connor SAJ, Siddiqui MA, Stewart VR, O’Flynn EAM (2008) The relationship of transverse sinus stenosis to bony groove dimensions provides an insight into the aetiology of idiopathic intracranial hypertension. Neuroradiology 50:999–1004PubMedCrossRef Connor SAJ, Siddiqui MA, Stewart VR, O’Flynn EAM (2008) The relationship of transverse sinus stenosis to bony groove dimensions provides an insight into the aetiology of idiopathic intracranial hypertension. Neuroradiology 50:999–1004PubMedCrossRef
22.
Zurück zum Zitat Bono F, Giliberto C, Mastrandrea C et al (2005) Transverse sinus stenoses persist after normalization of the CSF pressure in IIH. Neurology 65:1090–1093PubMedCrossRef Bono F, Giliberto C, Mastrandrea C et al (2005) Transverse sinus stenoses persist after normalization of the CSF pressure in IIH. Neurology 65:1090–1093PubMedCrossRef
23.
Zurück zum Zitat Farb RI, Forghani R, Lee SK et al (2007) The venous distension sign: a diagnostic sign of intracranial hypotension at MR imaging of the brain. AJNR Am J Neuroradiol 28:1489–93PubMedCrossRef Farb RI, Forghani R, Lee SK et al (2007) The venous distension sign: a diagnostic sign of intracranial hypotension at MR imaging of the brain. AJNR Am J Neuroradiol 28:1489–93PubMedCrossRef
24.
Zurück zum Zitat Rohr A, Jensen U, Riedel C et al (2010) MR imaging of the optic nerve sheath in patients with craniospinal hypotension. AJNR Am J Neuroradiol 31:1752–7PubMedCrossRef Rohr A, Jensen U, Riedel C et al (2010) MR imaging of the optic nerve sheath in patients with craniospinal hypotension. AJNR Am J Neuroradiol 31:1752–7PubMedCrossRef
Metadaten
Titel
The entire dural sinus tree is compressed in patients with idiopathic intracranial hypertension: a longitudinal, volumetric magnetic resonance imaging study
verfasst von
Axel Rohr
Jan Bindeballe
Christian Riedel
Andreas van Baalen
Thorsten Bartsch
Lutz Doerner
Olav Jansen
Publikationsdatum
01.01.2012
Verlag
Springer-Verlag
Erschienen in
Neuroradiology / Ausgabe 1/2012
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-011-0850-6

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