Research Article
Asymmetries of Transverse Sinuses in Patients with Menière Disease and Non-Migrainous Headache
Giampiero Neri*
,
Letizia Neri,
Giovanni Sanese,
Klajdi Xhepa,
Andrea Mazzatenta,
Anna Rita Fetoni,
Giuseppe Chiarella
Issue:
Volume 13, Issue 3, June 2025
Pages:
32-42
Received:
17 May 2025
Accepted:
13 June 2025
Published:
26 June 2025
DOI:
10.11648/j.ajim.20251303.11
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Abstract: Menière's disease (MD) is a chronic inner ear disorder characterised by vertigo, fluctuating hearing loss, and fullness, frequently associated with migraine. The aetiology of MD is multifactorial but unclear. Endolymphatic hydrops (EH) is the histopathological marker. The correlation between venous disorders and MD is described in the literature. Our study aims to evaluate the incidence of Transverse Sinus Asymmetries (TSA) in patients with Menière Disease (MD) and non-migrainous headaches to test a physiopathological hypothesis. Materials and Methods: We conducted a retrospective study of 32 patients with symptoms of MD and non-migrainous headaches who presented to TSA on Magnetic Resonance Imaging (MR). Each patient underwent clinical evaluation, Audiometry, impedanceometry, VHIT, VEMPS, RM Angiography (RMA), transcranial colour doppler ultrasound (TCD) to study the intracranial venous system and vascular flow. Results: All patients were diagnosed as probable in 41% and certain in 59%. On RMA results, 91% showed TSA. We propose four TSA stages. RMA showed 83% left TS hypoplasia and 17% right TS hypoplasia. All patients with TSA showed MD. Patients with left TSA showed right MD; patients with right TSA showed left or bilateral MD. We used TCD in 15 patients: 10 patients showed alteration or flow reversal. In 5 subjects was not possible due to mastoid ossification. Conclusions: Ultimately, a clear association exists between TS absence or hypoplasia in many Menière’s patients with non-migrainous headaches. Moreover, there is a correspondence between the side of MD and TSA, which is contralateral. Our study suggests to follow-up patients with TSA to prevent the onset of EH.
Abstract: Menière's disease (MD) is a chronic inner ear disorder characterised by vertigo, fluctuating hearing loss, and fullness, frequently associated with migraine. The aetiology of MD is multifactorial but unclear. Endolymphatic hydrops (EH) is the histopathological marker. The correlation between venous disorders and MD is described in the literature. O...
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