Article Figures & Data
Figures
- Fig 1.
MR imaging of the craniocervical region in healthy subjects: gadolinium-enhanced 3D-T1 MPRAGE sagittal acquisitions, thick MIP reconstructions (FOV = 232 × 256 mm2, matrix = 232 × 256, slice thickness = 1 mm, slices per slab = 160–208, TR/TE = 2200/2.09–4.68 ms, bandwidth = 140–240 Hz/pixel.) Parallel acquisition was performed in the generalized autocalibrating partially parallel acquisition mode, with reference line phase encoding. A, Classic OEV origin from the torcular herophili (asterisk). The OEV courses intraosseously within the occipital squama (arrows) and exists the skull proximal to the foramen magnum to join the suboccipital veins. B, An OEV originating from the distal superior sagittal sinus. The black arrow indicates the superior sagittal sinus; the black arrowhead, the straight sinus.
- Fig 2.
Venous phase of an SCTV obtained with a 320–detector row MDCT in a patient with pseudotumor cerebri syndrome. Posterior (A) and right lateral (B) projections. A dilated OEV (double arrows) originates from the torcular herophili (asterisk), consisting of several intraosseous and extracranial veins with various exit zones from the occipital squama. A hypoplastic transverse sinus is documented on the right side (thick arrow), and a severe transverse sinus intrinsic stenosis from an arachnoid granulation is seen on the left side (thin arrow). The double arrowheads indicate the superior sagittal sinus.
- Fig 3.
Venous phase of an SCTV with a 320–detector row MDCT in a patient with pseudotumor cerebri syndrome before (A and B) and after (C and D) left transverse sinus stent placement, anterior Towne projections (A and C), and left posterior oblique projections (B and D). There is a marked reduction of the OEV (small arrow) after stent placement in the left transverse sinus (double arrows), which has recovered its normal caliber. Note the size reduction of the right transverse sinus (arrowhead) proximal to an intrinsic stenosis after stent placement due to preferential drainage of the superior sagittal sinus into the stented transverse sinus.
Tables
PTCS (n = 46) Control (n = 92) P Value Age (mean) (yr) 35.6 ± 9.9 41.1 ± 12.3 .01 Female/male 40:6 62:30 .01 CSF opening pressure (mean) (range) (cm H2O) 34 ± 9 (22–65) (n = 44/46) Patients treated with stenting 29/46 Prestenting pressure gradient (mean) (range) (mm Hg) 9 (6–15) (n = 29/46) Poststenting pressure gradient (No.) (range) (mm Hg) 1 (0–2) (n = 29/46) Group 1 (PTCS) (n = 46) Group 2 (Control) (n = 92) P Value Prevalence of OEV (No.) 65.2% (30) 31.5% (29) <.0003 Male 4/6 (66.6%) 9/30 (30.0%) Female 24/40 (60.0%) 20/62 (32.2%) Osseous segment diameter (mean) (range) (mm) 2.3 (1–7) 1.6 (0.5–3) <.0049 Extracranial segment diameter (mean) (range) (mm) 3.3 (1.8–10) 2.3 (1–7) <.0001 - Table 3:
Comparison of OEV characteristics of patients with PTCS before and after transverse sinus stenting
Before Stenting (n = 17) After Stenting (n = 17) P Value Osseous segment diameter (mean) (range) (mm) 2.6 (1.5–4) 1.8 (1–2.1) <.06 Extracranial segment diameter (mean) (range) (mm) 3.7 (2–7) 2.6 (1–3.25) <.0045
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