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

  • Diagnostic Neuroradiology
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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.

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neuroradiology, University Clinic of Schleswig-Holstein Campus Kiel, Arnold-Heller-Str. 9, 24105, Kiel, Germany

    Axel Rohr, Jan Bindeballe, Christian Riedel & Olav Jansen

  2. Department of Neuropediatrics, University Clinic of Schleswig-Holstein Campus Kiel, Kiel, Germany

    Andreas van Baalen

  3. Department of Neurology, University Clinic of Schleswig-Holstein Campus Kiel, Kiel, Germany

    Thorsten Bartsch

  4. Department of Neurosurgery, University Clinic of Schleswig-Holstein Campus Kiel, Kiel, Germany

    Lutz Doerner

Authors
  1. Axel Rohr
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  2. Jan Bindeballe
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  3. Christian Riedel
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  4. Andreas van Baalen
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  5. Thorsten Bartsch
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  6. Lutz Doerner
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  7. Olav Jansen
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Correspondence to Axel Rohr.

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Rohr, A., Bindeballe, J., Riedel, C. et al. The entire dural sinus tree is compressed in patients with idiopathic intracranial hypertension: a longitudinal, volumetric magnetic resonance imaging study. Neuroradiology 54, 25–33 (2012). https://doi.org/10.1007/s00234-011-0850-6

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  • DOI: https://doi.org/10.1007/s00234-011-0850-6

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