Cerebral venous sinus stenosis should not be neglected when cerebral artery stenosis is confirmed: a case report

Abstract

Purpose

Cerebral venous sinus stenosis (CVSS) is easily neglected in clinical setting due to its nonspecific symptoms. In patients with cerebral arterial stenosis (CAS), the symptoms caused by CVSS are often mistakenly thought of being attributed to CAS. In this case, we aimed to highlight the clinical manifestations and treatment strategies of CVSS comorbid with CAS.

Materials and methods

We present an 83-year-old female who complained a series of nonspecific and non-focal neurological deficits such as tinnitus, head noise, dizziness, etc. She was initially diagnosed as CAS and underwent anti-CAS medication orally for over 2 years, whereas her symptoms were still aggravating.

Results

Magnetic resonance venography (MRV) and magnetic resonance imaging (MRI) displayed severe stenoses at bilateral sigmoid-transverse sinus conjunctions, and thus, the patient underwent intravenous stenting finally. Her aforementioned symptoms significantly attenuated after venous stenting and even disappeared gradually at 3-month, 6-month and 1-year follow-up.

Conclusions

This paper revealed that cerebral venous outflow disturbance should not be overlooked when the nonspecific and non-focal neurological deficits could not be explained by cerebral artery disease. For this arteriovenous condition, intravenous stenting may be a feasible and effective way for symptoms relieving.

Keywords:

• Arteriovenous condition
• cerebral arterial stenosis
• cerebral venous sinus stenosis
• nonspecific symptom
• stenting

Acknowledgments

We would like to thank all patient and doctors who participated in this study for their cooperation.

Disclosure of interest

The authors report no conflict of interest.

Ethical statement

Written informed consent was obtained from the patient for publication of this Case report and any accompanying images.

Author contributions

ZW and JD designed this study, followed up this case and wrote this paper. JC provided the figures in this study, gave some advice about the demonstrations on the phenomenon and co-wrote the paper. YD revised the manuscript and refined the use of English. XJ and RM contributed to the conception and design of this study, proposed the amendments and co-wrote the paper. RM takes full responsibility for the data, the analyses and interpretation, and the conduct of the research.

Data availability statement

The data that support the findings of this study are available from the corresponding author, RM, upon reasonable request.

Additional information

Funding

This work was supported by the National Key R&D Program of China under Grant [2017YFC1308400]; the National Natural Science Foundation under Grant [81371289]; and the Project of Beijing Municipal Top Talent for Healthy Work of China under Grant [2014-2-015].