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Sinus vein thrombosis conundrum: Persistent empty sella vs. flexible optic nerve sheath.
Gahl Greenberg1, David M Steinberg2, Ophira Salomon3
1Department of Diagnostic Imaging, Neuroradiology section, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. Affiliated with Tel Aviv University, Faculty of Medical and Health Sciences, Tel Aviv, Israel.
Journal of the Neurological Sciences
|October 21, 2024
Summary
Cerebral sinus vein thrombosis impacts optic nerve sheath width, which improves with thrombus resolution. However, pituitary gland flattening is not reversed by thrombus recanalization.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Cerebral sinus vein thrombosis (CSVT) can affect nearby structures.
- The impact of CSVT on the pituitary gland and optic nerve sheath requires further investigation.
Purpose of the Study:
- To investigate the effect of thrombotic burden in CSVT on pituitary gland height, bony sella, and optic sheath width.
- To analyze the relationship between venous drainage patterns and these anatomical changes.
Main Methods:
- Retrospective cohort study of 90 patients with CSVT (2000-2022).
- Analysis of CT/V and MR/V scans to assess dural sinus patency and dominant drainage.
- Measurement of pituitary dimensions and optic sheath width.
- Statistical analysis using regression models and non-parametric tests.
Main Results:
- Overall thrombus burden did not correlate with pituitary height.
- A significant inverse relationship was found between improvement in superficial thrombus score and optic nerve sheath width (p=0.010).
- Optic sheath width decreased as thrombus burden improved.
Conclusions:
- Thrombus recanalization favorably impacts optic nerve sheath diameter.
- Pituitary gland flattening in CSVT patients is not reversed by thrombus recanalization, irrespective of temporal improvement.
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