title: The entire dural sinus tree is compressed in patients with idiopathic intracranial hypertension: a longitudinal, volumetric magnetic resonance imaging study.
abstract: BACKGROUND
  The objective of this study was to explore the volumetric alterations of dural sinuses in patients with idiopathic intracranial hypertension (IIH).
  
  
  METHODS
  Standardized cranial magnetic resonance imaging (MRI) was used in 17 patients prior to and following treatment of IIH and in seven controls. Magnetic resonance venographies (MRV) were employed for (a) judgement of circumscript dural sinus stenoses and (b) computation of sinus volumes. Cross-sectional areas (CSA) of the superior sagittal sinuses (SSS) were measured on T2-weighted images. Results of the initial MRIs were compared to those on follow-up MRIs and to results of controls.
  
  
  RESULTS
  Stenoses of the transverse sinuses (TS) resulting in cranial venous outflow obstruction (CVOO) were present in 15/17 (88%) patients, normalizing in 7/15 cases (47%) after treatment of IIH. CVOO was not detected in the control group. Segmentation of MRV revealed decreased dural sinus volumes in patients with IIH as compared to controls (P = 0.018). Sinus volumes increased significantly with normalization of intracranial pressure independent from disappearing of TS stenoses (P = 0.007). The CSA of the SSS were normal on the initial MRIs of patients with IIH and increased on follow-up after treatment (P < 0.001). However, volumetries displayed overlap in patients and controls.
  
  
  CONCLUSIONS
  Patients with IIH not only exhibit bilateral stenoses of the TS as has been reported, but volume changes of their entire dural sinus system also occur. The potential etiopathological and diagnostic roles of these changes are discussed.
authors.affiliation: Department of Neuroradiology, University Clinic of Schleswig-Holstein Campus Kiel, Arnold-Heller-Str. 9, 24105, Kiel, Germany. Axel.Rohr@gmx.de
authors.forename: Axel
authors.initials: A
authors.lastname: Rohr
authors.forename: Jan
authors.initials: J
authors.lastname: Bindeballe
authors.forename: Christian
authors.initials: C
authors.lastname: Riedel
authors.forename: Andreas
authors.initials: A
authors.lastname: van Baalen
authors.forename: Thorsten
authors.initials: T
authors.lastname: Bartsch
authors.forename: Lutz
authors.initials: L
authors.lastname: Doerner
authors.forename: Olav
authors.initials: O
authors.lastname: Jansen
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D003392:Cranial Sinuses / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007427:Intracranial Pressure; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011559:Pseudotumor Cerebri / Q000503:physiopathology* / Q000628:therapy; D012851:Sinus Thrombosis, Intracranial / Q000503:physiopathology* / Q000628:therapy