Evidence map›Paper›PMID 35333949›Full record

ArticleNeuroradiology2022

Brain herniation (encephalocele) into arachnoid granulations: prevalence and association with pulsatile tinnitus and idiopathic intracranial hypertension.

Eric R Smith, M Travis Caton, Javier E Villanueva-Meyer, Justin Remer, Laura B Eisenmenger, Amanda Baker, Vinil N Shah, Adelyn Tu-Chan, Karl Meisel, Matthew R Amans

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neuroradiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Pediatric brain herniation into the dural venous sinuses: a case series and review of the literature.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
    Review
  3. Article
  4. Article
  5. Article
  6. Review
  7. Uncommon Locations for Brain Herniations Into Arachnoid Granulations: 5 Cases and Literature Review.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2025
    Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Eric R SmithDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., San Francisco, CA, 94117, USA.ORCID http://orcid.org/0000-0002-6855-5104
M Travis CatonDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., San Francisco, CA, 94117, USA.ORCID http://orcid.org/0000-0003-1581-7702
Javier E Villanueva-MeyerDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., San Francisco, CA, 94117, USA.ORCID http://orcid.org/0000-0002-5910-0757
Justin RemerDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., San Francisco, CA, 94117, USA.ORCID http://orcid.org/0000-0002-8868-5387
Laura B EisenmengerDepartment of Radiology, University of Wisconsin, Madison, WI, USA.ORCID http://orcid.org/0000-0001-6764-4239
Amanda BakerDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., San Francisco, CA, 94117, USA.ORCID http://orcid.org/0000-0001-9973-5792
Vinil N ShahDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., San Francisco, CA, 94117, USA.ORCID http://orcid.org/0000-0003-0803-5067
Adelyn Tu-ChanDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0002-6783-8567
Karl MeiselDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0003-4938-2495
Matthew R AmansDepartment of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave., San Francisco, CA, 94117, USA. matthew.amans@ucsf.edu.ORCID http://orcid.org/0000-0002-8209-0534
University of California, San Francisco · USUniversity of Wisconsin–Madison · US

Funding

MR Imaging of Blood Flow in Pulsatile TinnitusR21DC016087 · NIDCD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI AMANS, MATTHEW, SALONER, DAVID A · 2017 to 2018
$436k
NIDCD NIH HHS R21 DC016087NIH HHS R21DC016087NIH HHS R56
6 · The paper itself

Abstract

purposeBrain herniation into arachnoid granulations (BHAG) of the dural venous sinuses is a recently described finding of uncertain etiology. The purpose of this study was to investigate the prevalence of BHAG in a cohort of patients with pulsatile tinnitus (PT) and to clarify the physiologic and clinical implications of these lesions.

methodsThe imaging and charts of consecutive PT patients were retrospectively reviewed. All patients were examined with MRI including pre- and post-contrast T1- and T2-weighted sequences. Images were reviewed separately by three blinded neuroradiologists to identify the presence of BHAG. Their location, signal intensity, size, presence of arachnoid granulation, and associated dural venous sinus stenosis were documented. Clinical records were further reviewed for idiopathic intracranial hypertension, history of prior lumbar puncture, and opening pressure.

resultsTwo hundred sixty-two consecutive PT patients over a 4-year period met inclusion criteria. PT patients with BHAG were significantly more likely to have idiopathic intracranial hypertension than PT patients without BHAG (OR 4.2, CI 1.5-12, p = 0.006). Sixteen out of 262 (6%) patients were found to have 18 BHAG. Eleven out of 16 (69%) patients had unilateral temporal or occipital lobe herniations located in the transverse sinus or the transverse-sigmoid junction. Three out of 16 (19%) patients had unilateral cerebellar herniations and 2/16 (13%) patients had bilateral BHAG.

conclusionIn patients with PT, BHAG is a prevalent MRI finding that is strongly associated with the clinical diagnosis of IIH. The pathogenesis of BHAG remains uncertain, but recognition should prompt comprehensive evaluation for IIH.

Indexed as

Brain DiseasesIntracranial HypertensionPseudotumor CerebriTinnitusArachnoidBrainCranial SinusesEncephaloceleHumansPrevalenceRetrospective StudiesArachnoid granulationBrain herniationIdiopathic intracranial hypertensionMagnetic resonance imagingPulsatile tinnitus

Identifiers

PMID35333949
PMCPMC9365727
OpenAlexW4220923310

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.