Skip to main content

Advertisement

SpringerLink
Log in

CTA/V detection of bilateral sigmoid sinus dehiscence and suspected idiopathic intracranial hypertension in unilateral pulsatile tinnitus

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

A Letter to the Editor to this article was published on 12 March 2018

Abstract

Purpose

This aimed to evaluate the prevalence and extent of bilateral sigmoid sinus dehiscence (SSD) and to explore the presence of idiopathic intracranial hypertension (IIH) in patients with unilateral pulsatile tinnitus (PT) with CTA/V.

Methods

Sixty PT patients (52 females; 40.4 ± 11.6 years [20–72]) who underwent CTA/V and 30 non-PT patients (27 females; 38.4 ± 14.7 years [12–62]) were enrolled in this study. The primary outcome measure was the radiographic presence of SSD. The index of transverse sinus stenosis (ITSS) was obtained by multiplying the stenosis scale values for each transverse sinus, and once was ≥ 4, the presence of IIH was suspected.

Results

The prevalence and extent of SSD on symptomatic side (78%; maximum transverse diameter, MTD 0.49 ± 0.23; maximum vertical diameter, MVD 0.50 ± 0.26 cm) were significantly higher and larger than those on asymptomatic side (50%, P < 0.001; MTD 0.35 ± 0.18, P = 0.006; MVD 0.30 ± 0.15 cm, P < 0.001) in the study group and those (20%, P < 0.001; MTD 0.36 ± 0.18, P = 0.073; MVD 0.30 ± 0.22 cm, P < 0.048) in the control group. The presence of SSD showed significant correlation with both PT (logistic regression analysis, OR 4.167 [1.450–11.97]; P = 0.008) and suspected IIH (OR 16.25 [1.893–139.5]; P = 0.011).

Conclusion

In PT patients, SSD has a significant correlation with PT and a potential correlation with IIH.

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

Similar content being viewed by others

References

  1. Mundada P, Singh A, Lingam RK (2015) CT arteriography and venography in the evaluation of pulsatile tinnitus with normal otoscopic examination. Laryngoscope 125(4):979–984

    Article  PubMed  Google Scholar 

  2. Schoeff S, Nicholas B, Mukherjee S et al (2014) Imaging prevalence of sigmoid sinus dehiscence among patients with and without pulsatile tinnitus. Otolaryngol Head Neck Surg 150:841–846

    Article  PubMed  Google Scholar 

  3. Eisenman DJ (2011) Sinus wall reconstruction for sigmoid sinus diverticulum and dehiscence: a standardized surgical procedure for a range of radiographic findings. Otol Neurotol 32(7):1116–1119. https://doi.org/10.1097/MAO.0b013e31822a1c7d

    Article  PubMed  Google Scholar 

  4. Wang GP, Zeng R, Liu ZH et al (2014) Clinical characteristics of pulsatile tinnitus caused by sigmoid sinus diverticulum and wall dehiscence: a study of 54 patients. Acta Otolaryngol 134(1):7–13

    Article  PubMed  Google Scholar 

  5. Liu Z, Dong C, Wang X et al (2015) Association between idiopathic intracranial hypertension and sigmoid sinus dehiscence/diverticulum with pulsatile tinnitus: a retrospective imaging study. Neuroradiology 57(7):747–753

    Article  PubMed  Google Scholar 

  6. Shaw GY, Million SK (2012) Benign intracranial hypertension: a diagnostic dilemma. Case Rep Otolaryngol 2012:814696

    PubMed  PubMed Central  Google Scholar 

  7. Grewal AK, Kim HY, Comstock RH et al (2014) Clinical presentation and imaging findings in patients with pulsatile tinnitus and sigmoid sinus diverticulum/dehiscence. Otol Neurotol 35(1):16–21. https://doi.org/10.1097/MAO.0b013e31829ab6d7

    Article  PubMed  Google Scholar 

  8. Horev A, Hallevy H, Plakht Y et al (2013) Changes in cerebral venous sinuses diameter after lumbar puncture in idiopathic intracranial hypertension: a prospective MRI study. J Neuroimaging 23(3):375–378

    Article  PubMed  Google Scholar 

  9. Riggeal BD, Bruce BB, Saindane AM, Ridha MA, Kelly LP, Newman NJ, Biousse V (2013) Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis. Neurology 80(3):289–295. https://doi.org/10.1212/WNL.0b013e31827debd6

    Article  PubMed  PubMed Central  Google Scholar 

  10. Saindane AM, Bruce BB, Riggeal BD, Newman NJ, Biousse V (2013) Association of MRI findings and visual outcome in idiopathic intracranial hypertension. Am J Roentgenol 201(2):412–418. https://doi.org/10.2214/AJR.12.9638

    Article  Google Scholar 

  11. Farb RI, Vanek I, Scott JN et al (2003) Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis. Neurology 60:1418–1424

    Article  CAS  PubMed  Google Scholar 

  12. Maralani PJ, Hassanlou M, Torres C et al (2012) Accuracy of brain imaging in the diagnosis of idiopathic intracranial hypertension. Clin Radiol 67(7):656–663

    Article  CAS  PubMed  Google Scholar 

  13. Morris PP, Black XD, Port XJ et al (2017) Transverse sinus stenosis is the most sensitive MR imaging correlate of idiopathic intracranial hypertension. AJNR Am J Neuroradiol 38(3):471–477. https://doi.org/10.3174/ajnr.A5055

    Article  CAS  PubMed  Google Scholar 

  14. Carvalho GB da S, Matas SL de A, Idagawa MH et al (2016) A new index for the assessment of transverse sinus stenosis for diagnosing idiopathic intracranial hypertension. J Neuro Intervent Surg 9(2):173–177

    Google Scholar 

  15. Dong C, Zhao P, Liu Z et al (2016) Association between the extent of sigmoid sinus dehiscence and an occurrence of pulsatile tinnitus: a retrospective imaging study. Clin Radiol 71:883–888

    Article  CAS  PubMed  Google Scholar 

  16. Liu Z, Chen C, Wang Z et al (2013) Sigmoid sinus diverticulum and pulsatile tinnitus: analysis of CT scans from 15 cases. Acta Radiol 54(7):812–816

    Article  PubMed  Google Scholar 

  17. Hou ZQ, Han DY (2011) Pulsatile tinnitus in perimenopausal period. Acta Otolaryngol 131(8):896–904. https://doi.org/10.3109/00016489.2011.567998

    Article  PubMed  Google Scholar 

  18. Otto KJ, Hudgins PA, Abdelkafy W, Mattox DE (2007) Sigmoid sinus diverticulum: a new surgical approach to the correction of pulsatile tinnitus. Otol Neurotol 28(1):48–53. https://doi.org/10.1097/01.mao.0000247814.85829.f6

    Article  PubMed  Google Scholar 

  19. Sismanis A (2011) Pulsatile tinnitus: contemporary assessment and management. Curr Opin Otolaryngol Head Neck Surg 19(5):348–357. https://doi.org/10.1097/MOO.0b013e3283493fd8

    Article  PubMed  Google Scholar 

  20. Wall M, George D (1991) Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain 114(Pt 1A):155–180

    PubMed  Google Scholar 

  21. Lansley JA, Tucker XW, Eriksen XM et al (2017) Sigmoid sinus diverticulum, dehiscence, and venous sinus stenosis: potential causes of pulsatile tinnitus in patients with idiopathic intracranial hypertension? AJNR Am J Neuroradiol 38(9):1783–1788. https://doi.org/10.3174/ajnr.A5277

    Article  CAS  PubMed  Google Scholar 

  22. Harvey RS, Hertzano R, Kelman SE et al (2014) Pulse-synchronous tinnitus and sigmoid sinus wall anomalies: descriptive epidemiology and the idiopathic intracranial hypertension patient population. Otol Neurotol 35:7–15

    Article  PubMed  Google Scholar 

  23. Friedman DI, Liu GT, Digre KB (2013) Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 81(13):1159–1165. https://doi.org/10.1212/WNL.0b013e3182a55f17

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Shuaishuai Xu & Jianrong Xu

  2. Department of Radiology, Liaocheng People’s Hospital, Liaocheng, Shandong, China

    Shidong Ruan

  3. Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

    Shanfeng Liu

  4. Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, China

    Ruozhen Gong

Authors
  1. Shuaishuai Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shidong Ruan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shanfeng Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jianrong Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ruozhen Gong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ruozhen Gong.

Ethics declarations

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of retrospective study formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xu, S., Ruan, S., Liu, S. et al. CTA/V detection of bilateral sigmoid sinus dehiscence and suspected idiopathic intracranial hypertension in unilateral pulsatile tinnitus. Neuroradiology 60, 365–372 (2018). https://doi.org/10.1007/s00234-018-1987-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-018-1987-3

Keywords

Search

Navigation