Venous hypertension caused by a meningioma involving the sigmoid sinus: case report

Abstract

Background Intracranial venous hypertension has been associated with a few cases of meningioma secondary to compression of the venous sinus. This is the rare case of small meningioma involving the sigmoid sinus leading to intracranial venous hypertension mimicking venous thrombosis. Case presentation A 39-year-old woman suffered visual dysfunction due to bilateral papilledema. Noncontrast head computed tomography (CT) showed no intracranial space-occupying lesions or hydrocephalus. Cerebrospinal fluid examination revealed high opening pressure. Various image inspections such as three-dimensional CT angiography, magnetic resonance imaging, and cerebral angiography demonstrated a small 2.5-cm lesion causing subtotal occlusion of the dominant right sigmoid sinus. No improvement of clinical manifestations was observed after medical treatment for 6 months, so right presigmoid craniectomy was performed. Operative findings revealed that the tumor was located predominantly involving the sigmoid sinus. The pathological diagnosis was fibrous meningioma. Postoperative fundoscopic examination showed improvement of bilateral papilledema. Conclusions We treated a patient presenting with intracranial hypertension due to a small meningioma involving the sigmoid sinus. This unusual case suggests that early surgical strategies should be undertaken to relieve the sinus obstruction.

Increased Intracranial Pressure Due to Transverse Sinus Compression by a Meningioma En Plaque

“…That is the reason why venographic studies are indicated in patients with a clinical diagnosis of IIH [ 4 ]. Our patient’s final cause of her lateral sinus occlusion turned out to be external compression of the lateral sinus by an MEP, which is very rare [ 5 ]. The final correct MRI interpretation was made with a follow-up imaging study.…”

“…It may cause an increase in ICP due to its mass effect. Venous hypertension resulting in an increase in ICP is rare and only a few cases have been reported secondary to compression of the venous sinus [ 5 ]. We are reporting a rarer case of increased ICP due to external compression of the venous sinus by a rare type of meningioma, meningioma en plaque (MEP).…”

Venous ectasia preceding intra-tumoral hemorrhage in a case of gliosarcoma with transverse sinus involvement

“…Sumi et al . presented a case of meningioma invading the sigmoid sinus, which resulted in intracranial hypertension due to venous hypertension [ 11 ]. Both cases involved low-grade solid, fibrous tumors, which potentially caused venous outflow obstruction or severe stenosis of the venous sinus.…”

Venous Pathologies and Interventions of the Head

“…Intraluminal causes of VS include cerebral vein and dural sinus thromboses as well as subocclusive or occlusive arachnoid granulations. Extraluminal, intracranial causes appear to be less common and are primarily described secondary to brain herniation syndromes, though any space-occupying lesion, such as a neoplasm, may cause VS. 8 9 Extraluminal, extracranial causes of VS with significant neurological symptoms are primarily traumatic in origin, for example, venous impingement due to displaced bones after traumatic injuries. Some atraumatic causes of extraluminal, extracranial VS with significant neurological symptoms have been described, such as Eagle's Syndrome and Jugular Bow-Hunter's syndrome.…”