title: Association between idiopathic intracranial hypertension and sigmoid sinus dehiscence/diverticulum with pulsatile tinnitus: a retrospective imaging study.
abstract: BACKGROUND
  The mechanism of occurrence of sigmoid sinus dehiscence/diverticulum (SSDD) in pulsatile tinnitus (PT) patients remains under debate. Its association with idiopathic intracranial hypertension (IIH) lacks evidence, which is important for therapeutic planning and improving the clinical outcome. This study aimed to evaluate the association between SSDD and IIH by comparing the prevalence of several established imaging features of IIH between PT patients with SSDD and healthy volunteers.
  
  
  METHODS
  Thirty-three unilateral PT patients with SSDD identified on CT images and 33 age- and sex-matched healthy volunteers underwent T1-weighted volumetric magnetic resonance imaging (MRI). The optic nerve, pituitary gland, transverse sinus, and ventricles were assessed. The prevalence of established IIH imaging features was compared between the two groups. Furthermore, the PT patients were divided into two subgroups: PT patients with dehiscence only and PT patients with diverticulum. The same statistical analysis was performed on each pathophysiologic entity respectively.
  
  
  RESULTS
  The PT patients with SSDD showed a significantly higher prevalence of empty sella (P < 0.001), flattened posterior sclera (P = 0.001), vertical tortuosity of the optic nerve (P = 0.001), protrusion of the optic nerve (P = 0.006), transverse sinus stenosis (P = 0.011), and distension of the optic nerve sheath (P = 0.000). There were no significant differences between the PT and control groups in the maximum widths of the third and fourth ventricles and the lateral ventricle size. In contrast to controls, the imaging findings persisted in both of pathophysiologic entities, except for transverse sinus stenosis.
  
  
  CONCLUSIONS
  Several IIH imaging features occur more frequently in PT patients with SSDD than in healthy individuals, which suggests a potential correlation between SSDD with PT and IIH.
authors.affiliation: Department of Radiology, Capital Medical University, Beijing Tongren Hospital, NO.1, Dongjiaominxiang Road, Beijing, 100730, China, lzhtrhos@163.com.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Liu
authors.forename: Cheng
authors.initials: C
authors.lastname: Dong
authors.forename: Xiao
authors.initials: X
authors.lastname: Wang
authors.forename: Xiaoyi
authors.initials: X
authors.lastname: Han
authors.forename: Pengfei
authors.initials: P
authors.lastname: Zhao
authors.forename: Han
authors.initials: H
authors.lastname: Lv
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
authors.forename: Zhenchang
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000328:Adult; D002561:Cerebrovascular Disorders / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D003392:Cranial Sinuses; D004240:Diverticulum / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D061330:Multidetector Computed Tomography; D011559:Pseudotumor Cerebri / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D014012:Tinnitus / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
references.citation: AJR Am J Roentgenol. 2013 Aug;201(2):412-8
references.pmid: 23883223
references.citation: Ann Indian Acad Neurol. 2013 Apr;16(2):229-33
references.pmid: 23956571
references.citation: No To Hattatsu. 2001 Jul;33(4):319-22
references.pmid: 11494574
references.citation: Otol Neurotol. 2007 Jan;28(1):48-53
references.pmid: 17195746
references.citation: Med Hypotheses. 2004;63(3):549-52
references.pmid: 15288385
references.citation: Acta Otolaryngol. 2014 Jan;134(1):7-13
references.pmid: 24032538
references.citation: Am J Otol. 1998 Jul;19(4):472-7
references.pmid: 9661757
references.citation: Crit Care. 2008;12(5):181
references.pmid: 18831721
references.citation: Acta Otolaryngol. 2011 Aug;131(8):896-904
references.pmid: 21521010
references.citation: Neurosciences (Riyadh). 2005 Jan;10(1):76-8
references.pmid: 22473191
references.citation: Curr Opin Otolaryngol Head Neck Surg. 2011 Oct;19(5):348-57
references.pmid: 22552697
references.citation: Acta Radiol. 2012 Jul;53(6):682-8
references.pmid: 22761347
references.citation: Acta Neurochir (Wien). 2012 Jan;154(1):89-92
references.pmid: 22065197
references.citation: Acta Radiol. 2013 Sep;54(7):812-6
references.pmid: 23550183
references.citation: J Neurol Sci. 2000 Aug 15;177(2):85-94
references.pmid: 10980304
references.citation: Otol Neurotol. 2014 Jan;35(1):7-15
references.pmid: 24270723
references.citation: Case Rep Otolaryngol. 2012;2012:814696
references.pmid: 22928139
references.citation: J Neurol Sci. 2013 Sep 15;332(1-2):80-5
references.pmid: 23850064
references.citation: Neuroradiology. 2013 Aug;55(8):955-961
references.pmid: 23708942
references.citation: J Neuroimaging. 2013 Jul;23(3):375-8
references.pmid: 22913783
references.citation: Otolaryngol Head Neck Surg. 2014 May;150(5):841-6
references.pmid: 24468899
references.citation: Otol Neurotol. 2014 Jan;35(1):16-21
references.pmid: 24005164
references.citation: J Neurosci Rural Pract. 2011 Jan;2(1):84-6
references.pmid: 21716829
references.citation: Crit Care. 2008;12(5):R114
references.pmid: 18786243
references.citation: AJNR Am J Neuroradiol. 2013 Dec;34(12):2354-9
references.pmid: 23744692
references.citation: J Laryngol Otol. 2007 Mar;121(3):201-8
references.pmid: 16995967
references.citation: Cephalalgia. 2013 Oct;33(13):1075-84
references.pmid: 23615489
references.citation: Eur Arch Otorhinolaryngol. 2009 Jun;266(6):803-6
references.pmid: 19352689
references.citation: Otol Neurotol. 2011 Sep;32(7):1116-9
references.pmid: 21799456
references.citation: Neuroradiology. 2012 Jan;54(1):25-33
references.pmid: 21340576
references.citation: Clin Radiol. 2012 Jul;67(7):656-63
references.pmid: 22309765
references.citation: Neurosurgery. 2009 Feb;64(2):E393-4; discussion E394
references.pmid: 19190447
references.citation: J Magn Reson Imaging. 2000 Dec;12(6):808-13
references.pmid: 11105018
references.citation: CMAJ. 2011 Nov 8;183(16):1881
references.pmid: 21788420
references.citation: J Child Neurol. 2010 Mar;25(3):294-9
references.pmid: 19638638