Abstract
Intracranial venous hypertension is a rare presentation of meningiomas in the transverse-sigmoid sinus region. We describe a case of a young patient presenting with intracranial hypertension due to a meningioma causing compression of the dominant sigmoid sinus. We were able to document the cerebral venous pressure gradient across the lesion confirming our hypothesis that compression of the sigmoid sinus from the meningioma was the cause of intracranial hypertension.The patient is a 17-year-old male who presented with intracranial hypertension due to meningioma at the right dominant sigmoid sinus, which was treated by a Simpson grade IV surgical resection followed by stereotactic radiosurgery. Following treatment, his papilledema resolved and he remains symptom-free at 18 months.In conclusion, venous manometry is a useful adjunct to diagnose intracranial hypertension in non-idiopathic causes of intracranial hypertension. A multimodal management approach of intracranial hypertension due to outflow obstruction from the dominant sinus led to an excellent recovery on follow up.
Highlights
Meningiomas are benign neoplasms that arise from arachnoid cap cells
Invasion of the venous sinuses by a meningioma can cause obstruction of the venous drainage leading to increases in the intracranial pressure, and venous infarctions [2]
We describe the case of a 17-year-old male who presented with intracranial hypertension due to a meningioma at the right dominant sigmoid sinus, which was treated by surgical debulking followed by stereotactic radiosurgery
Summary
Meningiomas are benign neoplasms that arise from arachnoid cap cells. The arachnoid cap cells protrude into the venous sinuses and are most abundant around the superior sagittal sinus. We describe the case of a 17-year-old male who presented with intracranial hypertension due to a meningioma at the right dominant sigmoid sinus, which was treated by surgical debulking followed by stereotactic radiosurgery. The patient is a 17-year-old male who presented with 3-month history of headache, worse in the morning and associated with blurry vision, nausea and vomiting He initially presented to an optometrist at an outside hospital, who detected bilateral papilledema and referred him for further workup. Based on the patient’s clinical signs of increased intracranial pressure and the pressure gradient of 26 mm Hg (normal:
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