The authors describe a patient with pseudotumor cerebri syndrome who showed at venography a giant arachnoid granulation in the left dominant transverse sinus and hypoplasia of the contralateral transverse sinus with high pressure proximal to the obstruction. Dilation of the left transverse sinuses with a stent reduced both the pressure gradient across the arachnoid granulation and the cerebral spinal fluid opening pressure with immediate symptomatic improvement, suggesting a causal relationship between venous outflow obstruction and pseudotumor cerebri syndrome.
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