PMC6743697_01
Magnetic resonance venography showed stenosis in the right transverse-sigmoid. (a) (White arrowheads) and in the superior sagittal sinus. (b) (Black arrowhead). On fluid-attenuated inversion recovery imaging, no ventricular enlargement or hydrocephalus is seen. (c and d). On T2-weighted imaging demonstrates accumulated cerebrospinal fluid in the bilateral optic nerve sheaths (white arrow). (e) And expansion of bilateral Meckel caves bilaterally (asterisk) (f).
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F1
We examined magnetic resonance (MR) venography depicted stenosis in the right transverse-sigmoid sinus and SSS stenosis [Figure 1a and b]. On MR imaging, hydrocephalus was considered unlikely [Figure 1c and d]. However, cerebrospinal fluid (CSF) was revealed with the optic nerve sheath on both sides, and there was enlargement of the Meckel caves bilaterally [Figure 1e and f].
The left internal carotid artery angiography reveals severe stenosis in the right transverse-sigmoid sinus and superior sagittal sinus. (a) Anteroposterior view (white arrowhead). (b) Lateral view (black arrowhead). (c) Right anterior oblique view (white arrow), and. (d) Left anterior oblique view (asterisk).
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F2
The right internal carotid artery angiography revealed severe stenotic change in the right transverse-sigmoid sinus and SSS [Figure 2].
Percutaneous transluminal angioplasty was performed using a 4 mm x 40 mm Jackal in the superior sagittal sinus (SSS) (white arrowhead). (a) And transverse sinus (TS) (black arrowhead) (b). Stenting is performed in the SSS and right TS portion because each venous pressure gradient had not improved. (c) (White arrow). (d) (Asterisk). The right ICAG demonstrates satisfactory stent patency 3 months after the treatment. (e) Anteroposterior view. (f) Right anterior oblique view. (g) Lateral view; and. (h) Left anterior oblique view.
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F3
The venous pressure gradients indicated over 8 mmHg between distal and proximal of SSS stenosis after stenting in the right TS; however, we decided to place 8 mm x 29 mm WALLSTENT stent in the SSS [Figure 3a-d]. The systolic venous pressure was smaller than that of pretreatment. Cerebral angiography 6 months after the procedure demonstrated good stents patency [Figure 3e-h].