Pseudotumor Cerebri Syndrome and Giant Arachnoid Granulation: Treatment with Venous Sinus Stenting

Hypertension intracrânienne idiopathique : stent ou non

“…À l'inverse, il existe des arguments pour la nature primaire de la sté nose veineuse. La pré sence de granulations arachnoïdiennes ou de cordage de Willis à l'inté rieur des sinus transverses et surtout l'efficacité immé diate et durable du stenting veineux chez des patients pré sentant des granulations arachnoïdiennes intrasinusiennes (Zheng et al, 2010) sont des arguments pour la nature primaire de la sté nose veineuse. Enfin, la publication de Bono et al (2005), dé montrant la persistance des sté noses veineuses sinusiennes aprè s normalisation de la pression du LCR, est un argument pour l'existence, chez certains patients, de sté noses fixes.…”

Hypertrophic Arachnoid Granulation of the Occipital Bone

“…Perfusion studies suggest that the ultrastructure of AGs can accurately replicate the unidirectional flow of CSF [9] and AGs are defined as giant when they fill the lumen of a dural sinus and cause local dilatation or filling defects [10,11], with subsequent increase in intracranial pressure [12]. some authors have suggested that giant AGs might be responsible for pseudotumor cerebri syndrome by obstructing the sinusal venous flow [13,14]. Moreover, because they are usually located within 3 cm of the midline at the entry of the cortical veins into the sagittal sinus [3,4] where there is a weakness of the dura mater, they could be regarded as arachnoid herniations secondary to intracranial CSF pulsation through dural defects into the sinus [15].…”

“…The finding of giant PGs has often been associated with pseudotumor cerebri and benign intracranial hypertension syndrome with headache, vertigo and blurred vision associated to papilledema [13]. Giant AGs can sometimes cause osteolytic phenomena and subperiosteal bleeding [21,22].…”

Giant Arachnoid Granulations in Headache Mimicking Migraine with Aura

“…When arachnoid granulations are enlarged, they are termed "giant". Previous reports have found these structures to be sometimes associated with headaches, and in some patients, idiopathic intracranial hypertension (IIH) may occur (1)(2)(3). The pathophysiology of these enlarged structures seen as filling defects on imaging is not clearly defined, although in some cases they are presumed to cause symptoms such as headache via pressure resulting from secondary venous sinus obstruction.…”