Papilloedema from Dural Venous Sinus Compression by Meningiomas

Area of Science:

• Neurology
• Neurosurgery
• Ophthalmology

Background:

• Intracranial mass lesions can cause venous hypertension by compressing dural venous sinuses (DVS).
• This compression can lead to intracranial hypertension presenting as isolated papilledema, mimicking idiopathic intracranial hypertension.
• Meningiomas are a potential cause of DVS compression and secondary intracranial hypertension.

Purpose of the Study:

• To report a series of patients with isolated papilledema caused by meningiomas compressing the DVS.
• To highlight diagnostic delays and the multidisciplinary treatment approaches required for this condition.

Main Methods:

• Retrospective case series of 16 patients diagnosed with isolated papilledema due to DVS-compressing meningiomas.
• Data collected from three institutions between 2012 and 2016.
• Review of diagnostic timelines and treatment interventions.

Main Results:

• Delayed diagnosis occurred in 10 out of 16 patients.
• Treatment involved a multidisciplinary approach with varied interventions.
• Interventions included acetazolamide, CSF-shunt, optic nerve sheath fenestration, surgery, radiation, and venous stenting.
• Two patients required anticoagulation for secondary venous thrombosis.

Conclusions:

• Meningiomas compressing DVS are an important, though rare, cause of isolated papilledema and intracranial hypertension.
• Timely diagnosis is often challenging, necessitating a high index of suspicion.
• Multidisciplinary management, often involving multiple sequential treatments, is essential for optimal patient outcomes.