Pengfei Zhao MD, Presenter: Nothing to Disclose

Zhenchang Wang MD, PhD, Abstract Co-Author: Nothing to Disclose

Junfang Xian MD, Abstract Co-Author: Nothing to Disclose

Fei Yan, Abstract Co-Author: Nothing to Disclose

Zhaohui Liu MD, Abstract Co-Author: Nothing to Disclose

Hong Jiang MD, Abstract Co-Author: Nothing to Disclose

Cheng Dong, Abstract Co-Author: Nothing to Disclose

Han Lv, Abstract Co-Author: Nothing to Disclose

Xiaoyi Han, Abstract Co-Author: Nothing to Disclose

To assess the imaging characteristics about dehiscent wall of dura sinus in patients presenting with pulsatile tinnitus (PT) on CT angiography and venography (CTA+V)

Following approval of the institutional review board, we reviewed all hospitalized patients with PT from 2008 to 2013 who underwent thorough clinical and laboratory tests, including otomicroscopic and audiometric evaluations, CTA+V and DSA. Finally, 13 patients diagnosed with the dehiscent bony wall of dural sinus as the causative finding and cured by surgical reconstruction were enrolled. CTA+V images were blindly evaluated by 2 experienced neuroradiologists for the location, extent and amount of the bony dehiscence as well as the presence of arachnoid granulation, dominant venous system and high jugular bulb.

The area of the defect ranged from 4＊4 to 6*11 mm(average 5*7 mm), consistent with the intra-operative results. The dehiscence involved the sigmoid sinus exclusively in 8 paitents while both the transverse sinus and the sigmoid sinuse in 5 patients. 8 patients were presented with dehiscence located in the lateral wall of dural sinus, 4 in the anterolateral wall and 1 in the anterior wall. The cranial part of sigmoid sinus with dehiscent wall were found in all 13 patients while the caudal part in 5 paients. Single dehiscence was detected in 11 patients while two dehiscences in 2 patients. For other imaging findings, the large arachnoid granulation beneath the transverse sinus was demenstrated in 11 patients; the high jugular bulb was revealed in 11 patients; the symptomatic side was consistent with the dominant side in all 11 patients with unilateral dominant venous system.

The dehiscence of dural sinus inducing PT mostly manifests as single defect of bony wall, involves the dominant side of venous system and the lateral wall of the dural sinus, coexists with a large arachnoid granulation beneath the transverse sinus and the high jugular bulb.

This paper is about a new curable cause of PT. Our results benefit the intra-operative localization of the bony dehiscence of dural sinus so as to eliminate the symptom with less damage.

Zhao, P, Wang, Z, Xian, J, Yan, F, Liu, Z, Jiang, H, Dong, C, Lv, H, Han, X, The Dehiscent Bony Wall of Dural Sinus in Patients Presenting with Pulsatile Tinnitus: The Evaluation with CT Angiography and Venography.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13016568.html