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Sigmoid Sinus Diverticulum

Sigmoid sinus diverticulum is a rare vascular finding due to an opening in the bone at the area of the sigmoid sinus creating a pouch, or diverticulum. Sometimes, there may be associated stenosis. The diverticulum may present as pulsatile tinnitus. Several case reports have demonstrated that treatment or endovascular coiling of this diverticulum can provide relief for a patients' symptoms. 

Diagnosis

Sigmoid sinus diverticulum can be diagnosed either by CT, CTA, MRI or MRV. Cerebral angiography provides definitive diagnosis

Sigmoid Sinus Diverticulum

Axial CT: Right sigmoid sinus diverticulum

Sigmoid Sinus Diverticulum

Venogram, showing right sigmoid sinus diverticulum

Sigmoid Sinus Diverticulum

Venogram, after coiling of the pouch, the diverticulum is closed

Treatment

If no other source is found for the patient's symptoms of pulsatile tinnitus, treatment of the diverticulum via endovascular coiling, if found on the same side of the patient's symptoms, can provide relief in reducing or eliminating this sound. 

BMC Sigmoid Sinus Diverticulum Physicians

physician photo
Director, Interventional Neuroradiology and Interventional Neurology

Associate Professor of Neurology, Neurosurgery and Radiology
Boston University School of Medicine
Boston Magazine Top Docs
Special Interests:

Acute stroke intervention; Cerebral aneurysms and AVMs; Carotid stenting; Dural AV fistulas, Embolization of nose bleeds & head/neck tumors; Neurocritical care; Vasospasm; Vertebroplasty


physician photo
Special Interests: Stroke, Cerebral Aneurysms, Arteriovenous Malformations, Arteriovenous Fistula, Vertebroplasty

References

1. Srinivasan Paramasivam, Sunil Furtado, Tomoyoshi Shigamatsu, Eric Smouha. Endovascular Management of Sigmoid Sinus DiverticulumInterv Neurol. 2016 Jun; 5(1-2): 76–80.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934488/