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Bilateral transverse sinus stenosis and idiopathic intracranial hypertension without papilledema in chronic tension-type headache

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Abstract

Previous MR studies have established that bilateral transverse sinus stenosis (BTSS) predicts idiopathic intracranial hypertension without papilledema (IIHWOP) in migraine. However, it is uncertain whether BTSS identifies IIHWOP in patients with chronic tension-type headache (CTTH): using cerebral MR venography this study aimed to address this question.

In a prospective study from February 2002 to December 2006, 198 consecutive patients with CTTH underwent MR venography. Of these patients, 58 underwent lumbar puncture to measure cerebrospinal fluid (CSF) pressure. MR venography and lumbar puncture were also performed in 45 agematched control subjects. BTSS was considered present when the signal flow was poor or lacking (flow gap) in the mid-lateral portion of both transverse sinuses. IIHWOP was diagnosed if the patient met the diagnostic criteria for idiopathic intracranial hypertension and did not have papilledema. Among the 198 patients with CTTH who underwent MR venography, 18 (9%) had BTSS. Thirteen of these 18 patients with BTSS underwent lumbar puncture, and nine (69.2%) had IIHWOP. CSF opening pressure was normal in all 45 patients as well as in all 45 controls with normal MR venography.

These data suggest that BTSS on MR venography is associated with increased intracranial pressure in the absence of papilledema in patients with headache mimicking CTTH.

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Authors and Affiliations

  1. Institute of Neurology, University Magna Græcia, Campus Germaneto, Viale Europa, 88100, Catanzaro, Italy

    F. Bono MD, C. Giliberto MD, D. Cristiano MD, G. Broussard MD, S. D’Asero MD, L. Mangone MD, C. Mastrandrea MD &  A. Quattrone MD

  2. Dept. of Neuroradiology, University Magna Græcia, Campus Germaneto,Viale Europa, 88100, Catanzaro, Italy

    F. Fera MD

  3. Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Cosenza, Italy

    D. Messina MD, F. Condino PhD &  A. Quattrone MD

  4. Clinica Neurologica, Policlinico Mater Domini, Campus Universitario, località Germaneto, Viale Europa, 88100, Catanzaro, Italy

    A. Quattrone MD

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  1. F. Bono MD
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  2. D. Messina MD
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  3. C. Giliberto MD
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  4. D. Cristiano MD
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  5. G. Broussard MD
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  6. S. D’Asero MD
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  7. F. Condino PhD
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  8. L. Mangone MD
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  9. C. Mastrandrea MD
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  10. F. Fera MD
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  11. A. Quattrone MD
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Corresponding author

Correspondence to A. Quattrone MD.

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Bono, F., Messina, D., Giliberto, C. et al. Bilateral transverse sinus stenosis and idiopathic intracranial hypertension without papilledema in chronic tension-type headache. J Neurol 255, 807–812 (2008). https://doi.org/10.1007/s00415-008-0676-2

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  • DOI: https://doi.org/10.1007/s00415-008-0676-2

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