Tomlinson Samuel B, Rahmani Redi, Jabarkheel Rashad, Kruszewski Adam M, Yoshor Daniel, Srinivasan Visish M
Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States.
Division of Neuro-Ophthalmology, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States.
J Neurol Surg Rep. 2025 Jul 22;86(3):e170-e174. doi: 10.1055/a-2650-6754. eCollection 2025 Jul.
Symptomatic intracranial hypertension is a rare presentation of meningiomas associated with compression and/or invasion of the dural venous sinuses. Establishing a clear link between tumor-induced venous outflow obstruction and elevated intracranial pressure is essential to determine the appropriate management strategy.
A 59-year-old female presented with headaches, imbalance, pulsatile tinnitus, and horizontal binocular diplopia secondary to bilateral abducens nerve dysfunction in the setting of a small tentorial meningioma compressing the dominant right transverse sinus. Venous manometry demonstrated elevated sinus pressures and a large pressure gradient across the lesion. Microsurgical resection improved the caliber of the transverse sinus and normalized intracranial pressures without the need for permanent venous stent placement.
Tentorial meningiomas infrequently result in venous outflow obstruction and symptomatic intracranial hypertension. Thorough workup including diagnostic angiography, venous manometry, and temporary stenting can be used to confirm the diagnosis. Surgical resection with or without permanent stent placement can restore venous drainage and alleviate debilitating symptoms.
症状性颅内高压是脑膜瘤的一种罕见表现，与硬脑膜静脉窦受压和/或侵犯有关。明确肿瘤引起的静脉流出道梗阻与颅内压升高之间的联系对于确定合适的治疗策略至关重要。
一名59岁女性，因小的小脑幕脑膜瘤压迫右侧优势横窦，继发双侧展神经功能障碍，出现头痛、平衡失调、搏动性耳鸣和水平性双眼复视。静脉测压显示窦压力升高，病变处存在较大压力梯度。显微手术切除改善了横窦管径，使颅内压恢复正常，无需放置永久性静脉支架。
小脑幕脑膜瘤很少导致静脉流出道梗阻和症状性颅内高压。包括诊断性血管造影、静脉测压和临时支架置入在内的全面检查可用于确诊。手术切除加或不加永久性支架置入可恢复静脉引流并缓解使人衰弱的症状。
