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Journal of Korean Neurosurgical Society > Volume 43(1); 2008 > Article
Journal of Korean Neurosurgical Society 2008;43(1): 48-50.
doi: https://doi.org/10.3340/jkns.2008.43.1.48
Giant Arachnoid Granulation Misdiagnosed as Transverse Sinus Thrombosis.
Hyuk Jin Choi, Chang Won Cho, Yoon Suk Kim, Jae Hun Cha
Department of Neurosurgery, Maryknoll Medical Center, Busan Catholic Health System, Busan, Korea. braincwc@hotmail.com
ABSTRACT
We experienced a case of giant arachnoid granulation misdiagnosed as dural sinus thrombosis. A 66-year-old woman presented with a one month history of progressive occipital headache. Computed tomography angiography and cerebral angiography showed a round filling defect at the transverse sinus which was speculated as a transverse sinus thrombosis. Anticoagulation therapy was performed to prevent worsening of thrombosis for 2 weeks and then a Gadolinium-enhanced magnetic resonance imaging scan was performed. The filling defect lesion at the transverse sinus revealed a non-enhancing granule with central linear enhancement, which was compatible with giant arachnoid granulation. We checked the intrasinus pressure difference across the lesion the through the dural sinus in order to exclude the lesion as the cause of headache. Normal venous pressure with no significant differential pressure across the lesion was noted. Headache was treated with medical therapy.
Key Words: Giant; Arachnoid granulation; Dural sinus thrombosis
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