Features of dural sinus thrombosis simulating pseudotumor cerebri

To characterize dural sinus thrombosis (DST) patients presenting with a syn drome simulating pseudotumor cerebri (PTC), medical records of patients ini tially diagnosed as having PTC between 1980 and 1995 were analysed. Inclusi on criteria were intracranial hypertension (IH) and a normal initial comput ed tomography (CT) scan. All patients underwent angiography or magnetic res onance imaging (MRI) and magnetic resonance venography (MRV). Patients with IH secondary to a determined disorder were excluded from the study. Forty- six patients were included, 12 patients had MRI/ MRV or angiography finding s compatible with DST and the remaining 34 patients had no vascular patholo gy on neuroimaging studies and mere considered to have PTC. No clinical or auxiliary findings differed between the two groups except for younger age, which delineated the PTC patients. Two patients with DST died during the st udy. Both were agitated, had a relatively rapid course of symptom progressi on, and a CSF pressure of over 40 cm water. We conclude that DST can be ide ntified in 26% of patients presenting with symptoms and signs typical of PT C. It may be impossible to differentiate between patients with and without DST if MRI/MRV or angiography are not performed in this scenario. Eur J Neu rol 6:601-604 (C) 1999 Lippincott Williams & Wilkins.