Pseudotumor Cerebri Syndrome and Giant Arachnoid Granulation: Treatment with Venous Sinus Stenting

The authors describe a patient with pseudotumor cerebri syndrome who showed at venography a giant arachnoid granulation in the left dominant transverse sinus and hypoplasia of the contralateral transverse sinus with high pressure proximal to the obstruction. Dilation of the left transverse sinuses with a stent reduced both the pressure gradient across the arachnoid granulation and the cerebral spinal fluid opening pressure with immediate symptomatic improvement, suggesting a causal relationship between venous outflow obstruction and pseudotumor cerebri syndrome.