Abstract
There is evidence that patients with multiple sclerosis (MS) and hydrocephalus share some common pathophysiological mechanisms. Alterations in CSF pressure are known to affect cerebral venous sinus geometry. To further explore these mechanisms, we measured the superior sagittal sinus (SSS) cross-sectional area 3 cm above the torcular using T2 images in 20 MS, 10 spontaneous intracranial hypotension (SIH), 21 hydrocephalus and 20 idiopathic intracranial hypertension (IIH) patients and compared with 20 matched controls. The SSS area was reduced by 25% in hydrocephalus (p = 0.0008), increased by 22% (p = 0.037) in SIH and unchanged in IIH compared to matched controls. In MS there was a 16% increase in SSS area (p = 0.01).The findings suggest that changes in SSS cross-sectional are common between MS and SIH patients, while in hydrocephalus and IIH these are different.
Highlights
In a recent paper by the current authors, multiple sclerosis (MS) was shown to be similar to normal pressure hydrocephalus (NPH) with regards to vascular compliance and pulsation propagation [1]
The sinus area was reduced by 25% and the circumference by 16% (p = 0.0008 and 0.0002 respectively)
In spontaneous intracranial hypotension (SIH) the sinus area was increased by 22% (p = 0.037)
Summary
In a recent paper by the current authors, MS was shown to be similar to normal pressure hydrocephalus (NPH) with regards to vascular compliance and pulsation propagation [1]. The correlation between MS and NPH could suggest that there may be a CSF absorption abnormality in MS similar to NPH. The walls of the sagittal sinus have been shown to move depending on changes in the transmural pressure. In a single case of chronic hydrocephalus, the sagittal sinus cross-sectional area was reduced [2], in 16 IIH patients the sagittal sinus cross-sectional area
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