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Fig 1. Case 1: A and B, Axial T2-weighted turbo spin-echo (A) and venography (B) using a microcatheter in the torcular herophili inserted through the left TS (arrows, known aplasia of the right TS). The left TS in the lateral projection shows high-grade narrowing distal to a filling defect assumed to be an arachnoid granulation. C, Pressure monitoring at different locations (in centimeters H2O). D, Placement of a self-expanding nitinol stent (Absolute, Guidant, Indianapolis, Ind; 8 mm in diameter, 6-cm in length). Stenosis is abolished after stent placement. E, Poststent placement on routine cranial CT. F and G, On follow-up, contrast-enhanced CT (F) and proton-weighted MR imaging (G) in the same axial section position demonstrate a new stenosis in the medial aspect of the left transverse sinus (arrows) proximal to the stent. H and I, Venous phase of right internal carotid artery angiography in the lateral projection (H) and maximum intensity projection of MRV in the lateral projection (I) confirm the finding. Arrows indicate pre-stent stenosis. J, Following lumbar puncture, MRV shows significantly better flow signal intensity in the left transverse sinus proximal and within the stent (arrows) with albeit some signal-intensity reduction believed to be due to the stent material. K, Cranial CT after insertion of a ventriculoperitoneal shunt.
