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

Rohr, Axel; Bindeballe, Jan; Riedel, Christian; Baalen, Andreas van; Bartsch, Thorsten; Doerner, Lutz; Jansen, Olav

doi:10.1007/s00234-011-0850-6

Cited by 52 publications

(42 citation statements)

References 21 publications

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“…The potential association between SSDD with PT and IIH lacks clinical evidence and needs further investigation. Several imaging features suggest the presence of IIH, including an empty sella [12][13][14], increased diameter of the optic nerve sheath (ONS) [15,16], flattened posterior sclera [15,17], vertical tortuosity of the optic nerve [15,18,14], transverse sinus stenosis [19,20], and decreased ventricle size [21]. These findings suggest that the association between SSDD with PT and IIH can be preliminarily evaluated by imaging.…”

Section: Introductionmentioning

confidence: 99%

Association between idiopathic intracranial hypertension and sigmoid sinus dehiscence/diverticulum with pulsatile tinnitus: a retrospective imaging study

et al. 2015

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Section: Introductionmentioning

confidence: 99%

Association between idiopathic intracranial hypertension and sigmoid sinus dehiscence/diverticulum with pulsatile tinnitus: a retrospective imaging study

et al. 2015

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“…However, all patients had documented IIH and some degree of venous sinus abnormality (stenosis, atresia or both) that could cause outflow abnormalities and influence hemodynamics across the entire dural sinus system, as has been proposed by others. 23 …”

Section: Discussionmentioning

confidence: 99%

Computational Modeling of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension

Levitt

McGah

Moon

et al. 2016

AJNR Am J Neuroradiol

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Background and Purpose Idiopathic intracranial hypertension has been associated with dural venous sinus stenosis in some patients, but the hemodynamic environment of the dural venous sinuses has not been quantitatively described. Here, we present the first such computational fluid dynamics model using patient-specific blood pressure measurements. Materials and Methods Six patients with idiopathic intracranial hypertension and at least one stenosis or atresia at the transverse-sigmoid sinus junction underwent MRV followed by cerebral venography and manometry throughout the dural venous sinuses. Patient-specific computational fluid dynamics models were created using MRV anatomy, with venous pressure measurements as boundary conditions. Blood flow and wall shear stress were calculated for each patient. Results Computational models of dural venous sinuses were successfully reconstructed in all six patients with patient-specific boundary conditions. Three patients demonstrated a pathologic pressure gradient (≥ 8 mm Hg) across four dural venous sinus stenoses. Small sample size precludes statistical comparisons, but average overall flow throughout the dural venous sinuses of patients with pathologic pressure gradients was higher than in those without (1041.00 ± 506.52 vs. 358.00 ± 190.95 mL/min). Wall shear stress was also higher across stenoses in patients with pathologic pressure gradients (37.66 ± 48.39 vs 7.02 ± 13.60 Pa). Conclusion The hemodynamic environment of the dural venous sinuses can be computationally modeled using patient-specific anatomy and physiological measurements in patients with idiopathic intracranial hypertension. There was substantially higher blood flow and wall shear stress in patients with pathological pressure gradients.

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“…[84] In another study Rohr et al found volume changes in the entire dural sinus system in IIH patients becoming normal after treatment and they suggested that ICP changes are linked to volume decrease of the whole sinus tree. [85] Other studies have demonstrated improvement in these stenoses after CSF removal. [86,87] It has also been postulated that following a relatively minor increase of ICP, a possible abnormal flexibility of transverses sinuses in this group could lead to a significant sinus stenosis and increase venous pressure unlike in normal individuals.…”

Section: New Insights From Neuro-imaging and Bilateral Transverse Sinmentioning

confidence: 93%

An update on the pathophysiology of idiopathic intracranial hypertension alias pseudotumor cerebri

Baykan

Eki̇zoğlu

Uzun

2015

Agri

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İdiyopatik intrakraniyal hipertansiyonun -diğer adıyla psödotümör serebrininpatofizyolojisi üzerine bir güncelleme SummaryIdiopathic intracranial hypertension (IIH) is a syndrome characterized by increased intracranial pressure of unknown cause, leading to severe headache, papilledema and visual disturbances. Its former name, pseudotumor cerebri, has gained popularity recently. The strongest and most consistent risk factors of IIH are obesity and female gender. Infrequently, IIH may present in the absence of papilledema showing a headache profile similar to chronic daily headache with migrainous features. There have been several proposed mechanisms to explain the etiology of this disorder associated with various clinical conditions. In recent years, some inflammatory factors, natriuretic peptides and aquaporins have been proposed as possible contributors of the pathogenesis. On the other hand, some investigators have reported that bilateral transverse sinus stenosis is seen in the majority of IIH patients; therefore, dural sinus stent placement is used in some patients. No single theory has been able to provide a comprehensive answer, and there is no consensus about the exact cause of IIH. The aim of this review was to discuss the new insights on the mysterious pathogenesis of IIH.

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

Abstract: 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.

Cited by 52 publications

References 21 publications

Association between idiopathic intracranial hypertension and sigmoid sinus dehiscence/diverticulum with pulsatile tinnitus: a retrospective imaging study

Association between idiopathic intracranial hypertension and sigmoid sinus dehiscence/diverticulum with pulsatile tinnitus: a retrospective imaging study

Computational Modeling of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension

An update on the pathophysiology of idiopathic intracranial hypertension alias pseudotumor cerebri

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