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AJNR - American Journal of Neuroradiology

Published ahead of print on January 31, 2008
doi: 10.3174/ajnr.A0930

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Neurologic Complications of Inferior Petrosal Sinus Sampling

C.D. Gandhi^c, S.A. Meyer^a, A.B. Patel^a,b, D.M. Johnson^a,b and K.D. Post^a

^a Departments of Neurosurgery,Mount Sinai School of Medicine, New York, NY
^b Departments of Radiology, Mount Sinai School of Medicine, New York, NY
^c Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ

View larger version (56K): [in this window] [in a new window]   Fig 1. A,B. Venograms performed after catheterization of IPS. A, AP venogram of right IPS (curved arrow) demonstrating normal opacification of the right sinus as well as cross-filling into the left IPS. The anterior pontomesencephalic vein (small arrows) is seen draining inferiorly into the vertebral plexus. B, Lateral venogram of right IPS demonstrating the anterior pontomesencephalic vein (small arrows) and reflux into the cranial aspect of the anterior mesencephalic vein (curved arrow).

View larger version (55K): [in this window] [in a new window]   Fig 2. A–C. Initial MR imaging after a change in the patient's neurologic examination. A, Axial T2-weighted MR imaging demonstrating diffuse edema within the pons. B, Sagittal T2-weighted MR imaging demonstrating the cranial-caudal extent of edema at the pontomedullary junction. C, Axial DWI MR imaging showing a region of restricted diffusion, highly suggestive of infarct, within the dorsal pons.

View larger version (135K): [in this window] [in a new window]   Fig 3. MR imaging at 3 months after IPSS. Axial T2-weighted MR imaging demonstrating near-complete resolution of edema within the brain stem but a region of hyperintensity within the dorsal pons corresponding to the region of infarction.