Cerebral venous sinus stenosis should not be neglected when cerebral artery stenosis is confirmed: a case report

Purpose: Cerebral venous sinus stenosis (CVSS) is easily neglected in clinical setting due to its nonspecific symptoms. In patients with cerebral arterial stenosis (CAS), the symptoms caused by CVSS are often mistakenly thought of being attributed to CAS. In this case, we aimed to highlight the clinical manifestations and treatment strategies of CVSS comorbid with CAS. Materials and methods: We present an 83-year-old female who complained a series of nonspecific and non-focal neurological deficits such as tinnitus, head noise, dizziness, etc. She was initially diagnosed as CAS and underwent anti-CAS medication orally for over 2 years, whereas her symptoms were still aggravating. Results: Magnetic resonance venography (MRV) and magnetic resonance imaging (MRI) displayed severe stenoses at bilateral sigmoid-transverse sinus conjunctions, and thus, the patient underwent intravenous stenting finally. Her aforementioned symptoms significantly attenuated after venous stenting and even disappeared gradually at 3-month, 6-month and 1-year follow-up. Conclusions: This paper revealed that cerebral venous outflow disturbance should not be overlooked when the nonspecific and non-focal neurological deficits could not be explained by cerebral artery disease. For this arteriovenous condition, intravenous stenting may be a feasible and effective way for symptoms relieving.