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David A. Kumpe, Jeffrey L. Bennett, Joshua Seinfeld, Victoria S. Pelak, Ashish Chawla, and Mary Tierney

preservation of vision. Traditional treatment of IIH consists of weight loss, diuretics, and headache prophylaxis. Surgical procedures such as lumboperitoneal, ventriculoperitoneal, or ventriculoatrial shunting and ONSF are reserved for those patients who experience unsuccessful medical management. None of these procedures, however, treat the underlying cause of the increased ICP. Focal stenoses in the dural sinus outflow have been demonstrated in 30%–93% of patients with IIH. 12 , 16 , 18 These stenoses characteristically occur in the lateral transverse sinuses and upper

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William C. Hanigan, Ken Fraser, Michael Tarantino, and Huan Wang

T he gradual modification of the embryonal mesh during the early development of the cerebral venous system can result in many congenital variations of the torcular herophili, dural sinuses, and cerebral veins. 4, 5, 17, 20, 24 The variations may be innocuous and present only diagnostic challenges 6, 11, 25 or may be associated with hydrocephalus, intracranial thrombosis, and hemorrhage, or potentially lethal systemic changes in the neonate. 9, 11, 14, 18 The latter conditions often present difficult management problems. 13, 19 In this case report, we

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Luigi A. Lanterna, Paolo Gritti, Ornella Manara, Gianluca Grimod, Gianmario Bortolotti, and Francesco Biroli

C erebral vein and dural sinus thrombosis predominates in young and middle-aged adults. Despite improvements in diagnosis and treatment, more than 15% of patients remain permanently disabled or die. 7 , 9 Recently, the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) has shown that the most common mechanism of acute death is transtentorial herniation due to hemorrhagic lesions or diffuse brain edema. 1 , 2 In these circumstances, decompressive surgery (DS) may be the treatment to choose as it promptly creates space for swelling

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Robbin de Goederen, Iris E. Cuperus, Robert C. Tasker, Bianca K. den Ottelander, Marjolein H. G. Dremmen, Marie-Lise C. van Veelen, Jochem K. H. Spoor, Koen F. M. Joosten, and Irene M. J. Mathijssen

intracranial hypertension (IIH). Patients suffering from IIH experience symptoms from intracranial hypertension such as disabling headaches and papilledema. Their ICP is indeed increased, but without an identifiable cause. 18 Over the years, researchers have found that many patients with IIH have increased ICP due to TS stenosis. 6 These stenoses can be resolved by stenting the sinus or by performing a lumbar puncture. In a study by Rohr et al., the authors measured the dural sinus volumes before and after lumbar puncture. 24 They reported that patients with IIH had

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Marc P. Sindou and Jorge E. Alvernia

S urgical treatment of meningiomas involving the major dural sinuses poses a dilemma to the surgeon: leave a fragment of the invasive lesion and have a higher rate of recurrence, or attempt a total removal and put the venous circulation at risk. The current tendency is to resect the tumor mass outside the sinus wall(s) and coagulate the remnant, followed if needed by en bloc removal of the residual fragment when complete sinus occlusion occurs. 5 , 15 , 19 , 33 , 61 , 70 Note that a commonly accepted belief is the decreased likelihood of a recurrence

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Stanley L. Barnwell, Van V. Halbach, Christopher F. Dowd, Randall T. Higashida, Grant B. Hieshima, and Charles B. Wilson

. These collateral vessels may drain to either cortical veins or superficial extracranial veins. The fistulas in these patients were notable for their drainage to subarachnoid veins, despite normal patency of the involved dural sinus. It appeared that shunting occurred into a vein that had drained to the sinus but had since lost its connection. In Case 1, the collateral veins drained over the occipital lobe to the superior sagittal sinus. The venous drainage in Case 2 flowed to parietal cortical veins, one of which was an intraparenchymal varix, and then to the vein of

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Fredric B. Meyer, Daniela Lombardi, Bernd Scheithauer, and Douglas A. Nichols

cavernous sinus, they can originate from other dural sinuses, as evidenced by this report. The designation “cavernous hemangioma” for this extra-axial lesion may be a misnomer. Although these masses are part of a spectrum of vascular malformations, they have characteristics suggestive of a neoplasm, including mass effect, encasement of neurovascular structures, growth often in pregnancy, and radiographic features suggestive of a tumor. The term “vascular malformation” includes arteriovenous malformations, venous and cavernous hemangiomas, and capillary telangiectases

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Jefferson Browder, Ann Browder, and Harry A. Kaplan

I n the course of a study of the cerebral dural sinuses, incidental findings were polypoid tumors in the superior sagittal and transverse sinuses. The two located in the caudal part of the superior sagittal sinuses were of sufficient size to produce some dilatation of each sinus at the level of the mass. The smaller nodules found in the transverse sinuses were similar in appearance and consistency to those in the superior sagittal sinus. One of these tumors located in a transverse sinus was approximately one half the size of those in the superior sagittal

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Cheng-Hong Toh, Yao-Liang Chen, Ho-Fai Wong, Kuo-Chen Wei, Shu-Hang Ng, and Yung-Liang Wan

without associated lymphadenopathy is extremely rare. 1, 4, 10, 12 Intracranial RDD usually appears as a well-defined, dura-based lesion and does not display locally aggressive features on neuroimages. To our knowledge, isolated intracranial RDD with dural sinus invasion has never been reported in the literature. In this article, we report the neuroimaging findings in two cases of isolated intracranial RDD with dural sinus invasion. Case Reports Case 1 Examination This 60-year-old woman presented with progressive dizziness and vertigo that had lasted for

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John A. Scott, Robert M. Pascuzzi, Peter V. Hall, and Gary J. Becker

T he treatment of dural sinus thrombosis with heparin anticoagulation and/or fibrinolysis is controversial. Favorable results have been reported; 4, 5, 12 however, complications related to systemic fibrinolysis have also occurred. 9, 15 A patient with widespread dural sinus thrombosis is described who was successfully treated with local infusion of the fibrinolytic agent urokinase (Abbokinase). Case Report This 33-year-old right-handed man was taken to the emergency room at a local hospital with a 24-hour history of progressive generalized headache