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A 69-year-old woman suffered attacks of hearing disturbance and vertigo for seven years. Her otologic and ophthalmological examinations did not show any significant findings. Cerebral magnetic resonance imaging revealed a cystic mass in the left cerebellar convexity. Computed tomography demonstrated a contrast defect of the distal left transverse sinus. Magnetic resonance imaging revealed a cyst protruding into the transverse sinus, and enlarging in the supine. Cerebral angiography demonstrated a congestive venous flow in the left transverse sinus, at the upstream of the cyst. At rest, the venous sinus pressure was 13 cm H2O at the upstream of the cyst and 8 cm H2O at the downstream. When the patient held a breath, the upstream pressure increased to 37 cm H2O, while the maximal downstream pressure was 22 cm H2O. A large AG protruding into the cranial dural sinus may cause intermittent venous congestion and associated otologic symptoms. Movements accompanied by a transient decrease in cardiac venous return and changes in head position can attribute to an enlargement of such AG.

A 65-year-old man presented with coma. The cranial computed tomography (CT) revealed a massive hematoma in the left cerebral hemisphere, accompanied by intraventricular hemorrhage (IVH) and ventriculomegaly. Contrast examination revealed ectatic superior ophthalmic veins (SOVs). The patient underwent emergent hematoma evacuation. Contrast CT performed on postoperative day (POD) 2 showed a remarkable reduction in the diameters of both SOVs. A second patient, a 53-year-old man, presented with consciousness disturbance and right hemiparesis. CT revealed a large hematoma in the left thalamus, accompanied by massive IVH. Contrast CT demonstrated the bold delineation of the SOVs. The patient underwent endoscopic IVH removal. Contrast CT performed on POD 7 showed a remarkable reduction in the diameters of both SOVs. A third patient, a 72-year-old woman, presented with severe headache. CT revealed diffuse subarachnoid hemorrhage and ventriculomegaly. Contrast CT demonstrated a saccular aneurysm on the internal carotid artery-anterior choroidal artery branching site with the bold delineation of the SOVs. The patient underwent microsurgical clipping. Contrast CT performed on POD 68 showed a remarkable reduction in the diameters of both SOVs. The SOVs may function as an alternative venous drainage pathway in the setting of acute intracranial hypertension due to hemorrhagic stroke.