Neuroophthalmological implications of the radiological finding of the transverse sinus

Visualization of transverse intracranial sinuses by means of standard radiograms of the skill is a rather unusual finding. In order to detect the radiological evidence of this important intracranial venous collector, the authors examined 5.638 radiograms, collected since January 1982 until December 1986 at the Neuroradiological Ophtalmic Centre of the University of Bologna. 87 cases (1.54%) resulted positive, with a prevalence of young (mean age 23 years) and female (88%) patients. Among these, an involvement of the optic nerve was the most consistent finding. In fact, it was observed in 47 cases (54%) suffering from: retrobulbar optic neuritis (25 cases), papillitis (13 cases), optic disk edema (6 cases), optic chiasma syndrome (2 cases) and stasis papilla (1 case). Moreover, the report of headache in 20 further cases may have significative implications with respect to the pathogenetic hypothesis about the accentuation of the transverse sinus. Our data suggest that a primitive inflammatory disorder, such as asymptomatic meningitis or meningoencephalitis--early developed in the life--, can induce a persistent local damage also with the radiological alteration. Thus, we presumed that this sign may represent a significant marker of a compromised anatomofunctional condition predisposing to relapsing inflammatory processes. A very interesting possible clinical correlation with demyelinating disorders is also discussed for its pathogenetic implications.