CSF Flow Dynamics and Volume Changes in Sigmoid Sinus Wall Dehiscence-Pulsatile Tinnitus with Idiopathic Intracranial Hypertension

Motivation: The mechanism of sigmoid sinus dehiscence (SSWD) in pulsatile tinnitus (PT) patients remains unclear. Goal(s): To assess the cerebrospinal fluid (CSF) dynamics and volume of SSWD-PT with intracranial hypertension by phase-contrast magnetic resonance imaging (PC-MRI). Approach: Thirty-five PT patients with SSWD and intracranial hypertension identified on dual-phase contrast-enhanced CT (DP-CECT) and brain magnetic resonance venogram (MRV), respectively. And 35 age-, gender-, and handiness-matched healthy volunteers. All participants underwent T1-weighted volumetric and PC-MRI. Results: The body mass index, regurgitant fraction and CSF volume were significantly higher and the mean velocity, peak velocity and mean flux were significantly slower in SSWD-PT. Impact: We found the CSF dynamics and volume changes in SSWD-PT with intracranial hypertension, which may be related to blood flow dynamics changes in sigmoid sinus and presence of PT. These results suggest treatment for SSWD-PT should be more comprehensive.