School of Medicine Publications
Document Type
Article
Publication Date
7-1-2026
Abstract
Transverse venous sinus stenosis (TVSS) is an underrecognized cause of intracranial hypertension that can mimic primary headache disorders. We report a woman with obesity and prior bariatric surgery who developed bifrontal headache with pulsatile tinnitus, dizziness, and visual blurring for 1 year. Orthostatic features and lack of response to therapy prompted further evaluation. Lumbar puncture revealed an opening pressure of 32 cm H2 O with immediate relief after cerebrospinal fluid removal. Magnetic resonance venography demonstrated severe TVSS, confirmed by cerebral angiography. The patient had left transverse sinus stenting with sustained improvement. This case highlights the importance of considering TVSS in persistent headaches.
Recommended Citation
Swamy, T., Bangash, A. A., Harris, C., & Maldonado, J. C. (2026). Not Just a Migraine: Transverse Venous Sinus Stenosis Presenting as Orthostatic Headache. Annals of Internal Medicine: Clinical Cases, 5(7), e260243. https://doi.org/10.7326/aimcc.2026.0243
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Publication Title
Annals of Internal Medicine Clinical Cases
DOI
10.7326/aimcc.2026.0243
Academic Level
faculty
Mentor/PI Department
Internal Medicine
Comments
© 2026 Authors. Published in partnership by the American College of Physicians and American Heart Association.
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