title: Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis.
abstract: OBJECTIVE
  Transverse sinus stenosis (TSS) is common in idiopathic intracranial hypertension (IIH), but its effect on the course and outcome of IIH is unknown. We evaluated differences in TSS characteristics between patients with IIH with "good" vs. "poor" clinical courses.
  
  
  METHODS
  All patients with IIH seen in our institution after September 2009 who underwent a high-quality standardized brain magnetic resonance venogram (MRV) were included. Patients were categorized as having a good or poor clinical course based on medical record review. The location and percent of each TSS were determined for each patient, and were correlated to the clinical outcome.
  
  
  RESULTS
  We included 51 patients. Forty-six patients had bilateral TSS. The median average percent stenosis was 56%. Seventy-one percent of patients had stenoses >50%. Thirty-five of the 51 patients (69%) had no final visual field loss. Eight patients (16%) had a clinical course classified as poor. There was no difference in the average percent stenosis between those with good clinical courses vs those with poor courses (62% vs. 56%, p = 0.44). There was no difference in the percent stenosis based on the visual field grade (p = 0.38). CSF opening pressure was not associated with either location or degree of TSS.
  
  
  CONCLUSIONS
  TSS is common, if not universal, among patients with IIH, and is almost always bilateral. There is no correlation between the degree of TSS and the clinical course, including visual field loss, among patients with IIH, suggesting that clinical features, not the degree of TSS, should be used to determine management in IIH.
authors.affiliation: Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Bryan D
authors.initials: BD
authors.lastname: Riggeal
authors.forename: Beau B
authors.initials: BB
authors.lastname: Bruce
authors.forename: Amit M
authors.initials: AM
authors.lastname: Saindane
authors.forename: Maysa A
authors.initials: MA
authors.lastname: Ridha
authors.forename: Linda P
authors.initials: LP
authors.lastname: Kelly
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Newman
authors.forename: Valérie
authors.initials: V
authors.lastname: Biousse
mesh_terms: D000328:Adult; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D019586:Intracranial Hypertension / Q000150:complications / Q000473:pathology*; D016014:Linear Models; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D054064:Transverse Sinuses / Q000473:pathology*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology; D014794:Visual Fields