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Cranial unilateral sinus stenoses in a case of malignant idiopathic intracranial hypertension

Poster Details

First Author: J.Paz Moreno-Arrones SPAIN

Co Author(s):    C. Sanchez Barahona              

Abstract Details



Purpose:

Idiopatic intracranial hypertension (IIH ) is a syndrome that causes an increase of intracranial pressure with no traceable cause. 3% have a malignant clinical course with quickly progressive visual loss. It has been reported a high percentage of patients with IIH have venous sinus stenoses.

Setting:

Principe de Asturias University Hospital

Methods:

Woman, 65 yo suffering of headache since three weeks and acute hearing and vision loss. The neurological examination revealed paresia of right sixth cranial nerve and deafness with computerized tomography, nuclear magnetic resonancy (NMR) and no systemic diseases. Ocular examination revealed a visual acuity of hand movements, unreactive mydriasis and severe bilateral hemorrhagic optic disc oedema. The opening pressure of lumbar puncture was 400 cm H2O, normal chemical and serological analysis.

Results:

Cranial venous angiography NMR phase showed a left transverse sinus stenoses. Patient was treated with two lumbar punctures, acetazolamide and methylprednisolone, with clinical improvement with progressive decrease of papillary edema, and a final visual acuity 0.5 in both eyes.

Conclusions:

A high percentage of patients suffering of IIH presented with transverse sinus stenoses. Recently, new diagnoses criteria require NMR and fleboNMR in atypical cases, as described above. Currently, there is controversy over whether the stenoses could cause-or-effect of IIH, and if the degree of stenoses affects visual prognosis. FINANCIAL INTEREST: NONE

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