Features of dural sinus thrombosis simulating pseudotumor cerebri

Area of Science:

• Neurology
• Radiology
• Vascular Medicine

Background:

• Pseudotumor cerebri (PTC) is often diagnosed based on symptoms of intracranial hypertension (IH).
• Dural sinus thrombosis (DST) can present with similar symptoms, potentially leading to misdiagnosis.
• Accurate differentiation is crucial for appropriate patient management.

Purpose of the Study:

• To characterize patients with dural sinus thrombosis (DST) who initially presented with symptoms mimicking pseudotumor cerebri (PTC).
• To determine the prevalence of DST in patients initially diagnosed with PTC.
• To identify factors that may help differentiate between DST and PTC.

Main Methods:

• Retrospective analysis of medical records of patients diagnosed with PTC between 1980 and 1995.
• Inclusion criteria: intracranial hypertension (IH) and normal initial CT scan.
• All patients underwent angiography, MRI, or MRV for definitive diagnosis.

Main Results:

• Out of 46 patients, 12 (26%) were diagnosed with DST based on imaging findings.
• 34 patients (74%) were diagnosed with PTC, with younger age being a distinguishing factor.
• Two patients with DST experienced rapid progression and died, highlighting the severity of the condition.

Conclusions:

• Dural sinus thrombosis (DST) is a significant differential diagnosis in patients presenting with symptoms of pseudotumor cerebri (PTC).
• Advanced neuroimaging (MRI/MRV or angiography) is essential for accurate diagnosis in suspected cases.
• Failure to perform advanced imaging may lead to misdiagnosis and delayed treatment of DST.