BackgroundCurrently, studies on the formation mechanism for the enlargement of arachnoid granulation (AG) are lacking. The impact of dyslipidemia on the formation of multiple large arachnoid granulations (LAGs) was studied in this research.MethodsThe study included patients diagnosed with cerebral venous sinus stenosis (CVSS) related to LAG. The number of LAGs was assessed via high-resolution black blood magnetic resonance imaging. The relationships between blood lipids and multiple LAGs were explored to evaluate the effects of dyslipidemia on the formation of multiple LAGs.ResultsA total of 163 participants with a diagnosis of LAG were included. The levels of total cholesterol (TC) (P = 0.004) and low-density lipoprotein cholesterol (LDL-c) (P = 0.01) in the multiple LAGs group were greater than those in the non-multiple LAGs group. Multivariate logistic regression analysis revealed that TC (odds ratio (OR), 2.19; 95% confidence interval (CI), 1.26–3.80; P = 0.006) and LDL-c (OR, 2.18; 95% CI, 1.16–4.07; P = 0.02) were independently associated with multiple LAGs.ConclusionsTC and LDL-c are independently related to multiple LAGs, indicating that dyslipidemia may be a potential cause of CVSS. Therefore, monitoring blood lipids may be necessary for patients with LAGs.