Published: 2022-05-27

Transverse sinus stenosis distribution in refractory chronic headache patients in Pelni hospital

Fritz Sumantri Usman, Haekal Alaztha, Erman Keneddy, Merlin Prisilia Kastilong, Beny Kurniawan, Soleh ., Lenny Octavinawaty


Background: Transverse sinus stenosis (TSS) is a common finding on MRI of patients with refractory chronic headaches. Bilateral TSS with severity >50% was found in almost all (93%) patients with idiopathic intracranial hypertension (IIH). IIH can lead to papilledema and result in loss of visual function. This study aimed to determine the prevalence of TSS in patients with refractory chronic headache at Pelni hospital, Jakarta.

Methods: This was a descriptive analytical study and conducted at Pelni hospital, Jakarta from January to June 2021, with a sample of patients suffering from refractory chronic headaches. Data were analyzed using SPSS version 24.

Results: There were 70 subjects, with a mean age of 52.97±13.29, the majority aged <60 years (65.7%), with the male sex being more dominant (62.9%). There were 39 people (55.7%) with TSS; as many as 37 with (52.9%) left TSS and 2 (2.8%) with right TSS. Bivariate analysis with Chi square showed no relationship between age and sex with the presence of TSS in patients with refractory chronic headache (p=0.798 and p=0.487).

Conclusions: TSS was associated with the incidence of IIH. However, this finding has not yet been proven to be significant. This study also did not find a correlation between age and gender with the incidence of TSS.


Transverse sinus stenosis, Refractory chronic headache, Idiopathic intracranial hypertension

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Favoni V, Pierangeli G, Cirillo L, Toni F, Abu-Rumeileh S, LaMorgia C, et al. Transverse sinus stenosis in refractory chronic headache patients: an observational study. Front Neurol. 2019;10:1287.

Rizzoli P, Mullally W. Headache. Am J Med. 2019;131:17-24.

D’Antona L, Matharu M. Identifying and managing refractory migraine: barriers and opportunities?. The Journal of Headache and Pain 2019;20(1):89.

Riggeal B, Bruce B, Saindane A, Ridha M, Kelly L, Newman N, et al. Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis. American Academy of Neurology. 2013;80(3):289-95.

Morris PP, Black DF, Port J, Campeau N. Transverse sinus stenosis is the most sensitive mr imaging correlate of idiopathic intracranial hypertension. AJNR Am J Neuroradiol. 2017;38(3):471-7.

Burger IM, Murphy KJ, Jordan LC, Tamargo RJ, Gailloud P. Safety of cerebral digital subtraction angiography in children: complication rate analysis in 241 consecutive diagnostic angiograms. Stroke. 2006;37(10):2535-9.

Athos. Fact sheet: Interventional neuroradiologist idiopathic intracranial hypertension and pulsatile tinnitus, new york. venous sinus stenosis. Available at Accessed 16 March 2022.

Massrey C, Altafulla JJ, Iwanaga J, Litvack Z, Ishak B, Oskouian RJ, et al. Variations of the transverse sinus: review with an unusual case report. Cureus. 2018;10(9):3248.

Mollan SP, Ali F, Hassan-Smith G, Hannah B, Deborah IF, Alenxandra JS. Evolving evidence in adult idiopathic intracranial hypertension: pathophysiology and management. J Neurol Neurosurg Psych. 2016;87(9):982-92.

Durst CR, Ornan DA, Reardon MA, Mehndiratta P, Mukherjee S, Starke RM, et al. Prevalence of dural venous sinus stenosis and hypoplasia in a generalized population. J NeuroIntervent Surg Published Online First: 2016:1-5.

Weinlander E, Derani T, Cornblath WT, DeLott LB. Intracranial hypertension in transgender patients. J Neuroophthalmol. 2019;39(2):232-3.

Zayit-Soudry S, Leibovitch I, Kesler A. Idiopathic intracranial hypertension after 40 years of age: clinical features in 23 patients. Eur J Ophthalmol. 2008;18(6):989-93.

Simone RD, Ranieri A, Cardillo G, Bonavita V. High prevalence of bilateral transverse sinus stenosis associated IIHWOP in unresponsive chronic headache sufferers: pathogenetic implications in primary headache progression. Cephalgia. 2011;31(6):763-5.