Syndrome simulating pseudotumor cerebri caused by partial transverse venous sinus obstruction in metastic prostate cancer

PURPOSE: To report a case of partial transverse venous sinus obstruction ca using a syndrome resembling pseudotumor cerebri. METHOD: Case report. A 61-year-old man developed decreased vision, bilatera l papilledema, and a highly increased cerebrospinal fluid opening pressure. Brain magnetic resonance imaging (MRI) disclosed a small, extra axial mass near the torcula, which was dismissed as an incidental meningioma because cerebral angiography showed sinus patency. RESULTS: The patient's vision worsened, Biopsy of the enlarging mass disclo sed metastatic prostate cancer. After radiation therapy, the mass shrank, m agnetic resonance angiography disclosed reopening of the transverse sinuses , and papilledema resolved, but visual fields remained severely compromised . CONCLUSION: Partial blockage of the dural venous sinus by a small mass near the torcula can cause a sufficient increase in intracranial pressure to pr oduce vision-threatening papilledema. (Am J Ophthalmol 2000;129:254-256, (C ) 2000 by Elsevier Science Inc. All rights reserved.).