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Abstract
Objective: Transverse sinus stenosis (TSS) is common in idiopathic intracranial hypertension (IIH), but its effect on the course and outcome of IIH is unknown. We evaluated differences in TSS characteristics between patients with IIH with “good” vs “poor” clinical courses.
Methods: All patients with IIH seen in our institution after September 2009 who underwent a high-quality standardized brain magnetic resonance venogram (MRV) were included. Patients were categorized as having a good or poor clinical course based on medical record review. The location and percent of each TSS were determined for each patient, and were correlated to the clinical outcome.
Results: We included 51 patients. Forty-six patients had bilateral TSS. The median average percent stenosis was 56%. Seventy-one percent of patients had stenoses >50%. Thirty-five of the 51 patients (69%) had no final visual field loss. Eight patients (16%) had a clinical course classified as poor. There was no difference in the average percent stenosis between those with good clinical courses vs those with poor courses (62% vs 56%, p = 0.44). There was no difference in the percent stenosis based on the visual field grade (p = 0.38). CSF opening pressure was not associated with either location or degree of TSS.
Conclusion: TSS is common, if not universal, among patients with IIH, and is almost always bilateral. There is no correlation between the degree of TSS and the clinical course, including visual field loss, among patients with IIH, suggesting that clinical features, not the degree of TSS, should be used to determine management in IIH.
GLOSSARY
- ATECO=
- auto-triggered elliptic-centric-ordered;
- GRE=
- gradient-recalled echo;
- GVF=
- Goldmann visual field;
- HVF=
- Humphrey visual field;
- ICP=
- intracranial pressure;
- IIH=
- idiopathic intracranial hypertension;
- IQR=
- interquartile range;
- LP=
- lumbar puncture;
- MIP=
- maximum intensity projections;
- MRV=
- magnetic resonance venography;
- TS=
- transverse sinus;
- TSS=
- transverse sinus stenosis;
- VF=
- visual field
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received May 24, 2012.
- Accepted September 7, 2012.
- © 2012 American Academy of Neurology
Disputes & Debates: Rapid online correspondence
- Bilateral transverse sinus stenosis is only one of the contributing factors involved in IIH
- Re: Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis - Author Reply
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