Skip to main content

Advertisement

SpringerLink
Log in

Occipital emissary vein existence and its impact on the diagnosis of idiopathic intracranial hypertension in pediatric patients

  • Paediatric Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to investigate the efficacy of occipital emissary vein (OEV) detection in the diagnosis of idiopathic intracranial hypertension (IHH) in the pediatric age group, and to compare the prevalence and luminal diameter of OEV in patients with IHH and in healthy control subjects.

Methods

Conventional magnetic resonance imaging findings were assessed in the patients with IHH and in healthy control subjects who were under the age of 18, by two observers. The presence and luminal dimension of OEV and transverse sinus stenosis were also evaluated and compared between these two groups with magnetic resonance venography techniques.

Results

The rate of OEV existence was 7 times higher in the IIH group compared to the control group based on the second observer outcome (p = 0.010, OR = 7.0), with a very good interobserver agreement (Ƙ = 0.85). The dimension of OEV ranged between 0.6 and 2.5 mm. There was no correlation found between the opening pressure and the dimension of OEV (p = 0.834).

Conclusion

In conclusion, OEV existence could be an additional radiological finding for diagnosing IHH among pediatric patients, alongside other conventional findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Kohli A, Vossough A, Mallery RM et al (2019) Magnetic resonance imaging findings in pediatric pseudotumor cerebri syndrome. Pediatr Neurol 99:31–39. https://doi.org/10.1016/j.pediatrneurol.2019.04.010

    Article  PubMed  PubMed Central  Google Scholar 

  2. Barmherzig R, Szperka CL (2019) Pseudotumor cerebri syndrome in children. Curr Pain Headache Rep 23:58. https://doi.org/10.1007/s11916-019-0795-8

    Article  PubMed  PubMed Central  Google Scholar 

  3. Avery RA, Shah SS, Licht DJ, Seiden JA, Huh JW, Boswinkel J, Ruppe MD, Chew A, Mistry RD, Liu GT (2010) Reference range for cerebrospinal fluid opening pressure in children. N Engl J Med 363:891–893. https://doi.org/10.1056/NEJMc1004957

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Bialer OY, Rueda MP, Bruce BB, Newman NJ, Biousse V, Am Saindane (2014) Meningoceles in idiopathic intracranial hypertension. AJR Am J Roentgenol 202:608–613. https://doi.org/10.2214/AJR.13.10874

    Article  PubMed  PubMed Central  Google Scholar 

  5. San Millan D, Kohler R (2014) Enlarged CSF spaces in pseudotumor cerebri. AJR Am Roentgenol 203:457–458. https://doi.org/10.2214/AJR.14.12787

    Article  Google Scholar 

  6. Degnan AJ, Levy LM (2011) Pseudotumor cerebri: brief review of clinical syndrome and imaging findings. AJNR Am J Neuroradiol 32:1986–1993. https://doi.org/10.3174/ajnr.A2404

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Morris PP, Black DF, Port J, Campeau N (2017) Transverse sinus stenosis is the most sensitive MR imaging correlate of idiopathic intracranial hypertension. AJNR Am J Neuroradiol 38:471–477. https://doi.org/10.3174/ajnr.A5055

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Hedjoudje A, Piveteau A, Gonzalez-Campo C, Mogheker A, Gailloud P, San Millan D (2019) The occipital emissary vein: a possible marker for pseudotumor cerebri. AJNR Am J Neuroradiol 40:973–978. https://doi.org/10.3174/ajnr.A6061

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Cakmak PG, Ufuk F, Yagci AB, Sagtas E, Arslan M (2019) Emissary veins prevalence and evaluation of the relationship between dural venous sinus anatomic variations with posterior fossa emissary veins: MR study. Radiol Med 124:620–627. https://doi.org/10.1007/s11547-019-01010-2

    Article  Google Scholar 

  10. Mallery RM, Rehmani OF, Woo JH et al (2019) Utility of magnetic resonance imaging features for improving the diagnosis of idiopathic intracranial hypertension without papilledema. J Neuroopthalmol 39:299–307. https://doi.org/10.1097/WNO.0000000000000767

    Article  Google Scholar 

  11. Helmke K, Hansen HC (1996) Fundamentals of transorbital sonographic evaluation of optic nerve sheath expansion under intracranial hypertension. I Experimental study Pediatr Radiol 26:701–705. https://doi.org/10.1007/BF01383383

    Article  CAS  PubMed  Google Scholar 

  12. Korkmazer B, Karaman AK, Kochan Kızılkılıç E, Unkun R, Arslan S, Uygunoglu U, Kızılkılıc O, Kocer N, Islak C (2023) Efficacy of dural sinus quantitative measurements in idiopathic intracranial hypertension. Clin Neuroradiol 33:545–554. https://doi.org/10.1007/s00062-022-01244-0

    Article  PubMed  Google Scholar 

  13. Gordon K (1997) Pediatric pseudotumor cerebri: descriptive epidemiology. Can J Neurol Sci 24:219–221. https://doi.org/10.1017/s031716710002182x

    Article  CAS  PubMed  Google Scholar 

  14. Gorkem SB, Doganay S, Canpolat M, Koc G, Dogan MS, Per H, Coskun A (2015) MR imaging findings in children with pseudotumor cerebri and comparison with healthy controls. Child Nerv Syst 31:373–380. https://doi.org/10.1007/s00381-014-2579-0

    Article  Google Scholar 

  15. Gilbert AL, Heidary G (2016) Update on the evaluation of pediatric idiopathic intracranial hypertension. Curr Opin Opthalmol 27:493–497. https://doi.org/10.1097/ICU.0000000000000317

    Article  Google Scholar 

  16. Friedman DI, Liu GT, Digre KB (2013) Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 81:1159–1165. https://doi.org/10.1212/WNL.0b013e3182a55f17

    Article  PubMed  Google Scholar 

  17. Hirfanoglu T, Aydın K, Serdaroğlu A, Havalı C (2015) Novel magnetic resonance imaging findings in children with intracranial hypertension. Pediatr Neurol 53:151–156. https://doi.org/10.1016/j.pediatrneurol.2015.03.028

    Article  PubMed  Google Scholar 

  18. Pekcevik Y, Pekcevik R (2014) Why should we report posterior fossa emissary veins. Diagn Interv Radiol 20:78–81. https://doi.org/10.5152/dir.2013.13203

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Topkapı, Koc University Hospital, Davutpaşa Cd. No:4 34010, Zeytinburnu, Istanbul, Turkey

    Evrim Özmen, Yunus Emre Şentürk, Ahmet Peker & Yusuf Öner

  2. Department of Pediatric Neurology, Koc University Hospital, Istanbul, Turkey

    Ayfer Arduç Akçay

Authors
  1. Evrim Özmen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ayfer Arduç Akçay
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yunus Emre Şentürk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ahmet Peker
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yusuf Öner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Evrim Özmen.

Ethics declarations

Conflict of interest

The authors did not receive support from any organization for the submitted work.

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

Was waived by the local Ethics Committee of Koc University in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

Informed consent

Was obtained from legal guardians.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Özmen, E., Akçay, A.A., Şentürk, Y.E. et al. Occipital emissary vein existence and its impact on the diagnosis of idiopathic intracranial hypertension in pediatric patients. Neuroradiology 66, 643–650 (2024). https://doi.org/10.1007/s00234-024-03303-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-024-03303-4

Keywords

Search

Navigation