Cerebral Transverse Sinus Morphology As Detected by MR Venography in Patients With Chronic Migraine

Object. The goal of this study was to document the hazards associated with pseudotumor cerebri resulting from transverse sinus thrombosis after tumor resection. Dural sinus thrombosis is a rare and potentially serious complication of suboccipital craniotomy and translabyrinthine craniectomy. Pseudotumor cerebri may occur when venous hypertension develops secondary to outflow obstruction. Previous research indicates that occlusion of a single transverse sinus is well tolerated when the contralateral sinus remains patent.Methods. The authors report the results in five of a total of 107 patients who underwent suboccipital craniotomy or translabyrinthine craniectomy for resection of a tumor. Postoperatively, these patients developed headache, visual obscuration, and florid papilledema as a result of increased intracranial pressure (ICP). In each patient, the transverse sinus on the treated side was thrombosed; patency of the contralateral sinus was confirmed on magnetic resonance (MR) imaging. Four patients required lumboperitoneal or ventriculoperitoneal shunts and one required medical treatment for increased ICP. All five patients regained their baseline neurological function after treatment. Techniques used to avoid thrombosis during surgery are discussed.Conclusions. First, the status of the transverse and sigmoid sinuses should be documented using MR venography before patients undergo posterior fossa surgery. Second, thrombosis of a transverse or sigmoid sinus may not be tolerated even if the sinus is nondominant; vision-threatening pseudotumor cerebri may result. Third, MR venography is a reliable, noninvasive means of evaluating the venous sinuses. Fourth, if the diagnosis is made shortly after thrombosis, then direct endovascular thrombolysis with urokinase may be a therapeutic option. If the presentation is delayed, then ophthalmological complications of pseudotumor cerebri can be avoided by administration of a combination of acetazolamide, dexamethasone, lumbar puncture, and possibly lumboperitoneal shunt placement.

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Diagnosis and treatment of headache probably attributed to cerebral venous sinus thrombosis

Clinical Management Issues ◽

10.7175/cmi.v8i4.966 ◽

2014 ◽

Vol 8 (4) ◽

pp. 97-101

Author(s):

Rosario Iannacchero ◽

Amerigo Costa ◽

Antonio Sergi ◽

Aida Squillace ◽

Giuseppe Vescio ◽

...

Keyword(s):

Chronic Migraine ◽

Sinus Thrombosis ◽

Rare Condition ◽

Transverse Sinus ◽

Cerebral Venous Sinus Thrombosis ◽

Warning Signs ◽

Venous Sinus ◽

Diagnosis And Treatment ◽

Secondary Headache ◽

Venous Sinus Thrombosis

Cerebral venous sinus thrombosis (CVST) is a rare condition whose most common and sometimes only symptom is headache. Alas, diagnosis and treatment of CVST is often delayed or overlooked because of its high clinical variability. Using guidelines advices in detecting warning signs or symptoms of secondary headaches might ease the diagnosis of CVST.The article presents the case of a woman who is in treatment for chronic migraine and assessed for secondary headache in a multidisciplinary outpatient headache program. Alert symptoms like sudden worsening headache presentation, along with anamnestic cues, prompted neuroimaging that detected left transverse sinus thrombosis whose onset was difficult to date.

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Intracranial MR Venography Using L ow-Field Magnet: Normal Anatomy and Variations in Nepalese Population

Journal of Nepal Medical Association ◽

10.31729/jnma.3 ◽

2012 ◽

Vol 52 (186) ◽

Cited By ~ 2

Author(s):

U K Sharma ◽

K Sharma

Keyword(s):

Imaging Modality ◽

Anatomic Variation ◽

Transverse Sinus ◽

Dural Sinus ◽

Cerebral Vein ◽

Mr Venography ◽

Internal Cerebral Vein ◽

Sagittal Sinus ◽

Vein Of Labbé ◽

Basal Vein Of Rosenthal

Introduction: Magnetic resonance (MR) venography is considered a reliable imaging modality for the evaluation of intracranial venous system. The purpose of this study was to evaluate the normal venous anatomy and its variations in Nepalese population using low fi eld MR technique. Methods: One hundred patients with normal MR imaging of brain underwent MR venographic study. MR venograms were performed in 0.35 T MR scanner using a contiguous 2D time-of–fl ight MR angiographic technique. Results: The fl ow gaps in the transverse sinus were seen in 47% of population, of which 91% occurred in the non-dominant side. Right transverse sinus was dominant in 73% population. Flow gap was observed in bilateral transverse sinus in one case, while it was seen in the dominant right transverse sinus in 6.3% population. Inferior sagittal sinus was observed in 11% cases. Internal cerebral vein was seen in 60 cases. Occipital sinus was observed in 4% of the cases. The basal vein of Rosenthal was observed in 34% of the cases, whereas vein of Labbe seen in 8% cases. Unilateralfl ow gap in the sigmoid sinus was seen in 5 cases. Conclusions: MR angiography done at low fi eld MR unit is a reliable tool in cerebral venous sinus assessment, particularly major dural sinuses. The fl ow gaps in transverse sinus are frequently encountered anatomic variation. Visualization of small veins like inferior sagittal sinus, basal vein of Rosenthal, vein of Labbe, internal cerebral vein was inferior in our study compared to other studies done in high fi eld MR unit. Keywords: Dural sinus, intracranial veins, MR venography.

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Comparison of different MR venography techniques for detecting transverse sinus stenosis in idiopathic intracranial hypertension

Journal of Neurology ◽

10.1007/s00415-005-0710-6 ◽

2005 ◽

Vol 252 (9) ◽

pp. 1021-1025 ◽

Cited By ~ 44

Author(s):

Francesco Fera ◽

Francesco Bono ◽

Demetrio Messina ◽

Olivier Gallo ◽

Pier Luigi Lanza ◽

...

Keyword(s):

Intracranial Hypertension ◽

Idiopathic Intracranial Hypertension ◽

Transverse Sinus ◽

Mr Venography ◽

Sinus Stenosis

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Republished: Reversible transverse sinus collapse in a patient with idiopathic intracranial hypertension

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2014-011606.rep ◽

2015 ◽

Vol 8 (4) ◽

pp. e16-e16 ◽

Cited By ~ 4

Author(s):

Halil Onder ◽

Rahsan Gocmen ◽

Yasemin Gursoy-Ozdemir

Keyword(s):

Intracranial Hypertension ◽

Lumbar Puncture ◽

Idiopathic Intracranial Hypertension ◽

Transverse Sinus ◽

Mr Venography ◽

Effect Relationship ◽

Cause And Effect ◽

Lumboperitoneal Shunt ◽

Before And After ◽

Transverse Sinuses

The association of idiopathic intracranial hypertension (IIH) with stenosis or narrowing of the transverse sinuses (TSs) is well known. However, there is debate as to whether the stenosis is a cause or consequence. Here we describe a case of IIH and narrowing of the TSs, with four relapses and recoveries after repeated CSF diversions with lumbar puncture (LP) over 2 months. Subsequently, implantation of a lumboperitoneal shunt (LPrS) ensured recovery. MR venography 20 months after LPrS showed normally calibrated TSs. We show repeated MR venography findings before and after the LPs, and discuss the pathogenesis of IIH in terms of the cause and effect relationship between IIH and sinus collapse.

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MRV BRAIN NORMALANATOMICAL VARIANTS IN INDIA POPULATION

10.36106/ijsr/7911323 ◽

2020 ◽

pp. 59-62

Author(s):

Vemireddy Sreechand Reddy ◽

Apoorva. C ◽

Ankamma Rao. D

Keyword(s):

Sinus Thrombosis ◽

Anatomical Variation ◽

Anatomical Variations ◽

Transverse Sinus ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Mr Venography ◽

Medical College ◽

Sagittal Sinus ◽

Dural Venous Sinus

Introduction Knowledge of variations in the cerebral dural venous sinus anatomy seen on magnetic resonance (MR) venography is essential to avoid over-diagnosis of cerebral venous sinus thrombosis (CVST). Very limited data is available on gender difference of the cerebral dural venous sinus anatomy variations Materials and Methods A retrospective study was conducted in NRI medical college in the Department of Radiodiagnosis for a duration of 3 years to study the normal anatomy of the intracranial venous system and its normal variation, as depicted by 3D MR venography, in normal adults and any gender-related differences. Results A total of (46 men, 54 women, age range 12 to 81 years), were included in the study. Most common indication for MR venography was headache (80%). Hypoplastic left transverse sinus was the most common anatomical variation in (25%) patients. Left transverse sinus was hypoplastic in more commonly in male in comparison to females (13 versus 12). Most common variation of superior sagittal sinus (SSS) was hypoplastic anterior one third SSS ,. Conclusion Hypoplastic left transverse sinus is the most common anatomical variation and more common in male compared to female in the present study. Other anatomical variations of dural venous sinuses are not significantly differ among both genders.

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Case Report: Traumatic vein of Labbé hemorrhagic infarction - a distinct neurosurgical entity

F1000Research ◽

10.12688/f1000research.6910.1 ◽

2015 ◽

Vol 4 ◽

pp. 586

Author(s):

Sunil Munakomi ◽

Bijoy Kumar

Keyword(s):

Traffic Accident ◽

Road Traffic ◽

Sinus Thrombosis ◽

Petrous Bone ◽

Transverse Sinus ◽

Uneventful Recovery ◽

Mr Venography ◽

Haemorrhagic Infarction ◽

Ct Head ◽

Vein Of Labbé

Traumatic vein of Labbé haemorrhagic infarction is a distinct neurosurgical entity which requires special attention due to the important nature of the area it drains and its higher propensity for early uncal herniation. Herein we discuss the case of a 55 year-old male presenting with altered sensorium following a road traffic accident. His computerized tomogram (CT) head was suggestive of traumatic vein of Labbé haemorrhagic infarction which was subsequently confirmed by magnetic resonance (MR) venography. Due to impending herniation, he underwent urgent craniotomy and evacuation of hematoma.The patient made an uneventful recovery and was subsequently discharged home.This diagnosis should always be kept in mind for a patient with petrous bone fracture, transverse sinus thrombosis and hematoma in the mid and posterior temporal lobe.

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