Cranial venous outflow obstruction in the pseudotumour syndrome: incidence, nature and relevance

Johnston, Ian; Kollar, Christopher; Dunkley, Scott; Assaad, Nazih; Parker, Glendon J.

doi:10.1054/jocn.2001.0986

Cited by 75 publications

(34 citation statements)

References 26 publications

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“…The importance of the focus of the investigations and index of suspicion was evident from the report of Johnston et al [74] who retrospectively reviewed 188 patients with PTS who had presented between 1968 and 1999. The group included 29 children.…”

Section: Prevalence Of Cranial Venous Outflow Obstruction In Pseudotumormentioning

confidence: 99%

“…For a general review of PTS please see reference 169a. Although the evidence is insu‰cient to establish such a unifying hypothesis on causation, nonetheless there is enough to suggest that some form of venous outflow pathology is present in a significant number of cases, the presence of which is likely to have been overlooked in the period when CT scanning was the basis of diagnosis [74]. Two recent developments make this an issue of significance.…”

Section: Introductionmentioning

confidence: 99%

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Cranial Venous Outflow Obstruction and Pseudotumor Cerebri Syndrome

Owler

Parker

Hálmagyi

et al. 2005

Advances and Technical Standards in Neurosurgery

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Section: Prevalence Of Cranial Venous Outflow Obstruction In Pseudotumormentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cranial Venous Outflow Obstruction and Pseudotumor Cerebri Syndrome

Owler

Parker

Hálmagyi

et al. 2005

Advances and Technical Standards in Neurosurgery

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“…3,14 Prior studies have attempted to describe the stenoses seen in patients with IIH, in some cases semiquantitatively. [15][16][17][18] Varying frequencies of TSS in patients with IIH have been reported, with generally a very high prevalence (65%-100%). [15][16][17]19 These differences can be explained by differences in the imaging techniques used to observe the stenoses (i.e., digital subtraction angiography, time-of-flight MRV, measurement of pressure gradients).…”

mentioning

confidence: 99%

Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis

et al. 2013

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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 5 0.44). There was no difference in the percent stenosis based on the visual field grade (p 5 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. Idiopathic intracranial hypertension (IIH) is a syndrome of isolated elevated intracranial pressure (ICP) of unknown etiology, responsible for visual loss from papilledema in about 25% of cases.

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“…A recent study by Nodelmann (2009) observed that jugular vein valve insufficiency in patients with PTC supports the hypothesis that increased ICP may be a result of a more general state of venous hypertension, possibly associated with obesity. Several studies focusing on the appearance of outflow obstruction on MRI and MRV Johnston et al, 2002;) produced inconclusive results due to the wide variations of radiological appearances of posterior fossa dural sinuses, which may be confused with a normal anatomical variant (Lee & Brazis, 2000). Higgins et al (2004) published a study comparing 20 patients with PTC who had undergone MRV and a control group of 40 healthy volunteers, strictly selected.…”

Section: Obstruction Of Venous Outflowmentioning

confidence: 99%