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Pseudotumor cerebri from cranial venous obstruction.
B L Lam1, N J Schatz, J S Glaser
1Bascom Palmer Eye Institute, University of Miami, FL 33101.
Ophthalmology
|May 1, 1992
Summary
Cerebral venous outflow impairment can cause dural sinus hypertension, leading to pseudotumor cerebri. Magnetic resonance angiography is effective for diagnosing venous outflow obstruction and guiding treatment.
Area of Science:
- Neurology
- Radiology
Background:
- Pseudotumor cerebri can result from dural sinus hypertension due to impaired cerebral venous outflow.
- This study investigates causes and diagnostic methods for cerebral venous outflow impairment.
Observation:
- Six patients with pseudotumor cerebri and venous outflow obstruction were identified.
- Causes included neck dissection, sigmoid sinus ligation, catheter thrombosis, and dural sinus thrombosis.
- Imaging modalities like CT, MRI, MR angiography, and conventional angiography were used to locate obstructions.
Findings:
- Magnetic resonance angiography effectively characterized venous flow and identified obstruction sites in two patients.
- Three patients achieved successful outcomes with medical therapy.
- One patient underwent optic nerve fenestration for treatment.
Implications:
- Cerebral venous outflow impairment is a significant factor in pseudotumor cerebri.
- Magnetic resonance angiography is a valuable noninvasive tool for diagnosis and monitoring.
- Outcomes vary, with some patients experiencing permanent visual loss, particularly those with catheter-related complications.