Changes in the appearance of venous sinuses after treatment of disordered intracranial pressure

Cerebral angiographic findings in idiopathic intracranial hypertension (IIH) and spontaneous intracranial hypotension (SIH) have been described. Conventional cerebral venography has demonstrated tapered stenoses and filling defects in the transverse sinuses of patients with IIH.1 These stenoses have also been found in >90% of IIH patients imaged with auto-triggered elliptic-centric-ordered three-dimensional gadolinium-enhanced MR venography (ATECO MRV).2 Conventional cerebral angiography demonstrated prominence of intracranial venous structures in patients with SIH.3 To date, MRI correlates of these dilated venous channels have not been described. This report discusses the use of ATECO MRV to demonstrate the normalization of venous sinus caliber associated with the resolution of these two disorders of intracranial pressure (ICP). ### Case 1. A 21-year-old woman was diagnosed with IIH. CSF opening pressure was 32.5 cm H2O. Months later, she was admitted to our institution with persistent headache and blurred vision despite maximal doses of acetazolamide. Examination revealed an obese woman with bilateral papilledema. CSF opening pressure remained elevated at 24 cm H2O. An MRI …