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Eosinophilic Granuloma of the Occipital Bone Presenting as Intracranial Venous Hypertension

Published online by Cambridge University Press:  18 September 2015

H. Wightman
Affiliation:
Department of Neurosurgery, Saint John Regional Hospital, Saint John
B. Wheelock*
Affiliation:
Department of Neurosurgery, Saint John Regional Hospital, Saint John
*
Department of Neurosurgery, Saint John Regional Hospital, Saint John, New Brunswick, Canada
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Abstract:

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Intracranial venous sinus thrombosis is an uncommon cause of pseudotumor cerebri. The diagnosis is often not confirmed on the rationale that treatment will not be altered. We report a case presenting a pseudotumor cerebri where the underlying pathology disclosed dural sinus thrombosis resulting from compression by an eosionophilic granuloma of the occipital bone. Routine CT of the head and Technetium-99m brain scan initially demonstrated neither tumor nor thrombosis. Plain skull x-rays subsequently revealed a lytic lesion of the occiput. When reinvestigated with CT using bone density windows the tumor was revealed. Excision of the tumor and a short course of cobalt therapy was curative. Special techniques in nuclear scanning, CT and MRI designed to improve the sensitivity for diagnosing venous sinus thrombosis are described. This case illustrates the importance of establishing a definitive diagnosis and shows the importance of pre-test consultation between clinicians and radiologists to ensure that specific investigative techniques are properly utilized.

Type
Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1991

References

REFERENCES

1.Cecil Textbook of Medicine. 18th ed. Wyngaarden, JB, Smith, LH. WB Saunders Co. 1988.Google Scholar
2.Gettelfinger, DM, Kokeman, EP. Superior sagittal sinus thrombosis. Arch Neurol 1977; 34: 26.CrossRefGoogle ScholarPubMed
3.Imai, WK, Everhart, FR, Sanders, JM. Cerebral venous sinus thrombosis: report of a case and review of the literature. Pediatrics 1982; 70: 965970.CrossRefGoogle ScholarPubMed
4.Lavin, PJM, Bone, I, Lamb, JT, et al. Intracranial venous thrombosis in the first trimester of pregnancy. J Neurol Neurosurg Psychiatry 1978; 41: 726729.CrossRefGoogle ScholarPubMed
5.Averbach, P. Primary cerebral venous thrombosis in young adults: diverse manifestations of an unrecognized disease. Ann Neurol 1978; 3: 81.Google Scholar
6.Ahlskog, JE, O’Neill BP. Pseudotumor cerebri. Ann Intern Med 1982; 97: 249256.CrossRefGoogle ScholarPubMed
7.Couch, R, Camfield PR, Tibbies JAR. The changing picture of pseudotumor cerebri in children. Can J Neurol Sci 1985; 12: 4850.CrossRefGoogle Scholar
8.Rose, A, Matson, DD. Benign intracranial hypertension in children. Pediatrics 1967; 39: 227237.CrossRefGoogle ScholarPubMed
9.Corbett, JJ. Problems in the diagnosis and treatment of pseudotumor cerebri. Can J Neurol Sci 1983; 10: 221229.CrossRefGoogle ScholarPubMed
10.Greer, M. Benign intracranial hypertension, I. Mastoiditis and lateral sinus obstruction. Neurology 1962; 12: 472474.CrossRefGoogle ScholarPubMed
11.Scully, RE, et al. Case preparation 20-1988. N Engl J Med 1988; 318: 13221328.Google Scholar
12.Zilkha, A, Diaz, A. Computed tomography in the diagnosis of superior sagittal sinus thrombosis. J Comput Assist Tomogr 1980; 4: 124126.CrossRefGoogle ScholarPubMed
13.D’Avella, D, et al. Diagnosis of superior sagittal sinus thrombosis by computerized tomography: report of two cases1. J Neurosurg 1984; 61: 11291131.CrossRefGoogle Scholar
14.Barnes, B, Winestock, DP. Dynamic radionucleotide scanning in the diagnosis of thrombosis of the superior sagittal sinus. Neurology 1977; 27: 656661.CrossRefGoogle Scholar
15.Front, D, et al. Superior sagittal sinus thrombosis: assessment with Tc-99m labelled red blood cells. Radiology 1986; 158: 453456.CrossRefGoogle Scholar
16.Baver, WM, Einhaupl, K, Heywang, SH, et al. MR of venous sinus thrombosis: a case report. Am J Neuroradiol 1987; 8: 713715.Google Scholar
17.Ashforth, RA, Melanson, D, Ethier, R. MR of deep cerebral venous thrombosis. Can J Neurol Sci 1989; 16: 417421.CrossRefGoogle ScholarPubMed