Intracranial hypertension secondary to a skull lesion without mass effect

•Intracranial hypertension due to a skull lesion reducing cerebral sinus patency is uncommonly reported.•Venous outflow obstruction should be considered in patients with a skull lesion without mass effect but elevated intracranial pressure.•Venographic evidence is essential for the diagnosis of sinus occlusion.

We report and discuss five patients with intracranial hypertension due to a skull lesion reducing cerebral sinus patency with a compressive, non-thrombotic mechanism. We illustrate the importance of a high level of suspicion for this condition in patients presenting with headache, papilledema and increased intracranial pressure in the absence of focal signs or radiological evidence of mass effect.