MedPix® Patient Chart - Case No: 13189 :: - Review Images

26 y.o. obese woman with a Hx of persistent and disabling (8/10) global headache and a recent onset of blurred vision

Ocular Exam: Papilledema & Ocular pressure of 46 cmH2O
LP (spinal tap) – Opening Pressure of 20.5 cmH2O
R Transverse sinus pressure gradient 13 mmHg (normal <4mmHg)

- Review Images for PT: 13189

• MR Venogram (MRV) showing right transverse sinus stenosis, proximal to the sigmoid sinus and interntal jugular vein (IJV) junction.

• Cerebral catheter arteriogram & venography demonstrate a high-grade right transverse-sigmoid sinus stenosis, distal to the vein of Labbe connection. The stenosis was estimated as at least 80% narrowing, to an approximate diameter of 1mm with a pressure gradient across the stenosis of 13 mmHg.

• Neurointerventional radiology endovascular procedure was successful with a balloon angioplasty and stent placement across the stenosis in the right transverse sinus.

- Review Images for PT: 13189

• Obstruction of venous outflow, eg, venous sinus stenosis/thrombosis, jugular vein compression
• Pseudotumor Cerebri (idiopathic intracranial hypertension)
• Decreased CSF absorption (i.e. arachnoid granulation)
• Increased cerebrospinal fluid (CSF) production (i.e. choroid plexus papilloma)
• Intracranial mass lesions (tumor, abscess)
• Obstructive hydrocephalus

- Review Images for PT: 13189

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Treatment not available without Diagnosis

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