{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:45:17Z","timestamp":1792806317952,"version":"4.5.0"},"reference-count":13,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>The authors report the case of a 30-year-old female patient with suspected Cushing\u2019s disease with an anatomical variation of hypoplastic inferior petrosal sinuses and nearly exclusive anterior drainage from the cavernous sinus, who underwent external jugular venous blood sampling with successful disease confirmation and microadenoma localization. The patient presented with signs and symptoms consistent with Cushing\u2019s syndrome, but with discordant preliminary diagnostic testing. She underwent attempted bilateral inferior petrosal sinus sampling; however, she had hypoplastic inferior petrosal sinuses bilaterally and predominantly anterior drainage from the cavernous sinus into the external jugular circulation. Given this finding, the decision was made to proceed with external jugular venous access and sampling in addition to internal jugular venous sampling. A positive adrenocorticotropic hormone (ACTH) response to corticotropin-releasing factor was obtained in the right external jugular vein alone, suggesting a right-sided pituitary microadenoma as the cause of her Cushing\u2019s disease. The patient subsequently underwent a transsphenoidal hypophysectomy that confirmed the presence of a right-sided ACTH-secreting microadenoma, which was successfully resected. She was hypocortisolemic on discharge and has had no signs of recurrence or relapse at 6 months postoperation.<\/jats:p>","DOI":"10.3171\/2019.11.jns192374","type":"journal-article","created":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T09:46:40Z","timestamp":1583488000000},"page":"522-525","source":"Crossref","is-referenced-by-count":4,"title":["External jugular venous sampling for Cushing\u2019s disease in a patient with hypoplastic inferior petrosal sinuses"],"prefix":"10.3171","volume":"134","author":[{"given":"Keyan A.","family":"Peterson","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Wake Forest University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christofer D.","family":"Burnette","sequence":"additional","affiliation":[{"name":"Department of Radiology, Wake Forest Baptist Health, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle M.","family":"Fargen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wake Forest University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Radiology, Wake Forest Baptist Health, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James L.","family":"West","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wake Forest University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen B.","family":"Tatter","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wake Forest University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey Q.","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wake Forest University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Cavernous sinus sampling in patients with Cushing\u2019s disease","volume":"38","author":"Burkhardt T","year":"2015","unstructured":"Burkhardt T, Flitsch J, van Leyen P, Sauer N, Aberle J, Grzyska U, : Cavernous sinus sampling in patients with Cushing\u2019s disease. Neurosurg Focus 38(2):E6, 2015"},{"key":"b2","series-title":"J Neurointerv Surg","first-page":"196","article-title":"Bilateral inferior petrosal sinus sampling: experience in 327 patients","volume":"9","author":"Deipolyi A","year":"2017","unstructured":"Deipolyi A, Bailin A, Hirsch JA, Walker TG, Oklu R: Bilateral inferior petrosal sinus sampling: experience in 327 patients. J Neurointerv Surg 9:196\u2013199, 2017"},{"key":"b3","series-title":"Diagn Interv Radiol","first-page":"132","article-title":"The role of bilateral inferior petrosal sinus sampling in the diagnostic evaluation of Cushing syndrome","volume":"18","author":"Deipolyi A","year":"2012","unstructured":"Deipolyi A, Karaosmano\u011flu A, Habito C, Brannan S, Wicky S, Hirsch J, : The role of bilateral inferior petrosal sinus sampling in the diagnostic evaluation of Cushing syndrome. 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