图1. 42岁,男性,右侧搏动性耳鸣,脑组织疝入静脉窦的蛛网膜颗粒(Brain herniation into arachnoid granulations,BHAG)。A和B,冠状位T2 Flair和T1增强MRI显示左侧颞叶后部BHAG,疝入横窦(环形圈)。C,轴位T2 MRI显示眼球后部变平,视神经头突出(protrusion of the optic nerve heads),视神经鞘蛛网膜下腔明显,提示颅内压升高。D,MR静脉造影显示双侧横窦狭窄,最明显的是左侧BHAG部位(白色箭头):
图2. BHAG与“简单”蛛网膜造粒的MR比较。79岁,男性,右侧搏动性耳鸣,无特发性颅内高压。A图,矢状位T1增强MR图像显示左侧枕部BHAG进入横窦;B图,右侧小脑BHAG进入横窦。C图,另一位患者的矢状位T1增强MR图像显示,在类似位置可见蛛网膜颗粒,而无BHAG:研究发现对于搏动性耳鸣的患者,在MRI上BHAG很常见,与临床诊断特发性颅内高压有关。. 2022 Sep;64(9):1747-1754. doi: 10.1007/s00234-022-02934-9. Epub 2022 Mar 25.Brain herniation (encephalocele) into arachnoid granulations: prevalence and association with pulsatile tinnitus and idiopathic intracranial hypertension