E-050 Effect of general anaesthesia on endovenous pressure measurement during dural sinus stenting for idiopathic intracranial hypertension

2017 ◽  
Author(s):  
El Mekabaty ◽  
E Obusez ◽  
C Chung ◽  
M Luciano ◽  
F Hui
Keyword(s):  
Intracranial Hypertension ◽  
General Anaesthesia ◽  
Pressure Measurement ◽  
Idiopathic Intracranial Hypertension ◽  
Dural Sinus

Predictors for venous sinus stent retreatment in patients with idiopathic intracranial hypertension

2016 ◽  
Vol 9 (12) ◽  
pp. 1228-1232 ◽  
Author(s):  
Amgad El Mekabaty ◽  
Nancy A Obuchowski ◽  
Mark G Luciano ◽  
Seby John ◽  
Charlotte Y Chung ◽  
...  
Keyword(s):  
African Americans ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Revision Rate ◽  
Normal Weight ◽  
Venous Sinus ◽  
Practical Significance ◽  
Dural Sinus ◽  
Obese Patients ◽  
Class Iii

BackgroundVenous sinus stenting for dural sinus stenoses is an emerging alternative to cerebrospinal fluid diversion in cases of medically refractory idiopathic intracranial hypertension. Juxta-stent ‘re-stenoses’ have been reported and managed alternatively with ventricular shunting or stent revision. Identification of factors that might predispose patients to recurrent narrowing may help to select or exclude patients with idiopathic intracranial hypertension for venous sinus stenting.MethodsWe retrospectively reviewed a prospectively maintained database spanning December 2011 to May 2015 of all patients with idiopathic intracranial hypertension who were screened for possible venous sinus stenting, including only patients who received a stent, noting symptomatic improvements, changes in opening lumbar puncture pressure, demographic characteristics, and any subsequent intervention after stent placement. Fisher's exact test and logistic regression were used to test each of seven potential predictors for retreatment.ResultsThere were eight revisions in 31 patients (25.8%). Among Caucasians, 8.0% required a revision compared with 100% of African-Americans (p<0.001). The c-index for race was 0.857. Body mass index (BMI) was also a significant predictor of revision (p=0.031): among class III obese patients the revision rate was 46.2% compared with 16.7% among class I and II obese patients and 0% among overweight to normal weight patients.ConclusionsBMI was a significant predictor of revision, suggesting that higher BMI may have a higher risk of revision. The small number of African-Americans in the study makes interpretation of the practical significance of the revision rate in these patients uncertain. None of the other studied factors was statistically significant.

Idiopathic intracranial hypertension without intracranial hypertension

2020 ◽  
pp. 10.1212/CPJ.0000000000001022
Author(s):  
Mattia Sansone ◽  
Michelangelo De Angelis ◽  
Leonilda Bilo ◽  
Vincenzo Bonavita ◽  
Roberto De Simone
Keyword(s):  
Physical Activity ◽  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Valsalva Manoeuvre ◽  
Dural Sinus ◽  
Daily Fluctuation ◽  
Csf Pressure ◽  
Postural Changes

The intracranial pressure (ICP) show large daily fluctuation, mainly due to postural changes and physical activity (e.g. it goes up to 470 mmH2O under Valsalva manoeuvre1). Consequently, the dural sinus must be sufficiently rigid in order to avoid its collapse during cerebrospinal fluid (CSF) pressure peaks. Hereby, we describe a patient with collapsible dural sinus associated with an intracranial hypertension syndrome without a detectable raised ICP, suggesting that a number of crucial assumptions on idiopathic intracranial hypertension with (IIH) or without papilledema (IIHWOP) might be discussed.

Dural sinus stent placement for idiopathic intracranial hypertension

2012 ◽  
Vol 116 (3) ◽  
pp. 538-548 ◽  
Author(s):  
David A. Kumpe ◽  
Jeffrey L. Bennett ◽  
Joshua Seinfeld ◽  
Victoria S. Pelak ◽  
Ashish Chawla ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Stent Placement ◽  
Idiopathic Intracranial Hypertension ◽  
Venous Pressure ◽  
Dural Sinus ◽  
Pressure Gradients ◽  
Pressure Measurements ◽  
Junction Region ◽  
Hemodynamic Deterioration

Object The use of unilateral dural sinus stent placement in patients with idiopathic intracranial hypertension (IIH) has been described by multiple investigators. To date there is a paucity of information on the angiographic and hemodynamic outcome of these procedures. The object of this study was to define the clinical, angiographic, and hemodynamic outcome of placement of unilateral dural sinus stents to treat intracranial venous hypertension in a subgroup of patients meeting the diagnostic criteria for IIH. Methods Eighteen consecutive patients with a clinical diagnosis of IIH were treated with unilateral stent placement in the transverse-sigmoid junction region. All patients had papilledema. All 12 female patients had headaches; 1 of 6 males had headaches previously that disappeared after weight loss. Seventeen patients had elevated opening pressures at lumbar puncture. Twelve patients had opening pressures of 33–55 cm H2O. All patients underwent diagnostic cerebral arteriography that showed venous outflow compromise by filling defects in the transverse-sigmoid junction region. All patients underwent intracranial selective venous pressure measurements across the filling defects. Follow-up arteriography was performed in 16 patients and follow-up venography/venous pressure measurements were performed in 15 patients. Results Initial pressure gradients across the filling defects ranged from 10.5 to 39 mm Hg. Nineteen stent procedures were performed in 18 patients. One patient underwent repeat stent placement for hemodynamic failure. Pressure gradients were reduced in every instance and ranged from 0 to 7 mm Hg after stenting. Fifteen of 16 patients in whom ophthalmological follow-up was performed experienced disappearance of papilledema. Follow-up arteriography in 16 patients at 5–99 months (mean 25.3 months, median 18.5 months) showed patency of all stents without in-stent restenosis. Two patients had filling defects immediately above the stent. Four other patients developed transverse sinus narrowing above the stent without filling defects. One of these patients underwent repeat stent placement because of hemodynamic deterioration. Two of the other 3 patients had hemodynamic deterioration with recurrent pressure gradients of 10.5 and 18 mm Hg. Conclusions All stents remained patent without restenosis. Stent placement is durable and successfully eliminates papilledema in appropriately selected patients. Continuing hemodynamic success in this series was 80%, and was 87% with repeat stent placement in 1 patient.

Unique variant of idiopathic intracranial hypertension dural sinus stenting

2020 ◽  
pp. 1-3
Author(s):  
Anthony M. Alvarado ◽  
Praneeta Nalluri ◽  
Andrew M. Alvarado ◽  
Alan Reeves ◽  
Michael G. Abraham
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Dural Sinus

Measurement of Blood Flow in the Superior Sagittal Sinus in Healthy Volunteers, and in Patients with Normal Pressure Hydrocephalus and Idiopathic Intracranial Hypertension with Phase-Contrast Cine MR Imaging

1996 ◽  
Vol 37 (1P1) ◽  
pp. 171-176 ◽  
Author(s):  
P. Gideon ◽  
C. Thomsen ◽  
F. Gjerris ◽  
P. S. Sørensen ◽  
F. Ståhlberg ◽  
...  
Keyword(s):  
Blood Flow ◽  
Intracranial Hypertension ◽  
Healthy Volunteers ◽  
Normal Pressure Hydrocephalus ◽  
Idiopathic Intracranial Hypertension ◽  
Superior Sagittal Sinus ◽  
Normal Pressure ◽  
Dural Sinus ◽  
Velocity Mapping ◽  
Sagittal Sinus

Purpose: To measure blood flow and velocity in the superior sagittal sinus. Material and Methods: MR velocity mapping was used to examine 14 healthy volunteers, 15 patients with normal pressure hydrocephalus (NPH), 3 patients with high pressure hydrocephalus (HPH), and 11 patients with idiopathic intracranial hypertension (IIH). Results: Mean blood flow was 443 ml/min in healthy volunteers with a tendency towards reduced blood flow with increasing age. In NPH patients significantly lower superior sagittal sinus blood flow values were found, but this difference was no longer significant when patients and controls were matched for age. In HPH and IIH patients blood flow and velocity were within the normal range. In one patient with thrombosis of the superior sagittal sinus the blood flow was reduced to 40 ml/min. Conclusion: MR velocity mapping methods may be of value in the assessment of blood flow in the dural sinuses in various pathologies resulting in dural sinus occlusion, such as dural sinus thrombosis, and for following the progress of these patients while undergoing treatment.

scholarly journals Quantitative imaging biomarkers for dural sinus patterns in idiopathic intracranial hypertension

2017 ◽  
Vol 7 (2) ◽  
pp. e00613 ◽  
Author(s):  
Dinah Zur ◽  
Reut Anconina ◽  
Anat Kesler ◽  
Svetlana Lublinsky ◽  
Ronen Toledano ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Quantitative Imaging ◽  
Imaging Biomarkers ◽  
Dural Sinus ◽  
Quantitative Imaging Biomarkers

scholarly journals Neuroendovascular Cerebral Sinus Stenting in Idiopathic Intracranial Hypertension

2019 ◽  
Vol 8 (2-6) ◽  
pp. 164-171
Author(s):  
Fawaz Al-Mufti ◽  
Vincent Dodson ◽  
Krishna Amuluru ◽  
Jessy Walia ◽  
Ethan Wajswol ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Case Series ◽  
Dural Sinus ◽  
Stent Insertion ◽  
Endovascular Management ◽  
Treatment Protocols ◽  
Cerebral Sinus ◽  
Sinus Stenosis ◽  
Visual Problems

Idiopathic intracranial hypertension (IIH) is a rare, ill-understood disease of significant morbidity. Because the pathophysiology is poorly understood, treatment protocols are not uniform and are directed towards alleviating the most common symptoms: headache and visual loss. In this review, we analyze 25 case series, all of which included IIH patients (n = 408) who were treated with placement of a venous sinus stent. Among 342 patients who had headache, 240 patients (70.2%) had improvement or resolution of headache after the stent insertion. Of the 217 patients documented to have visual problems, visual acuity was improved or stabilized in 161 patients (74.2%). Of the 304 patients with papilledema, 257 showed resolution or improved (84.5%). Of the 124 patients who presented with pulsatile tinnitus, it was resolved in 110 patients (88.7%) after stent placement. Endovascular management of dural sinus stenosis is therefore clinically efficacious in patients with IIH who have failed medical and surgical therapy.

Dural sinus collapsibility, idiopathic intracranial hypertension, and the pathogenesis of chronic migraine

2019 ◽  
Vol 40 (S1) ◽  
pp. 59-70 ◽  
Author(s):  
Roberto De Simone ◽  
Angelo Ranieri ◽  
Mattia Sansone ◽  
Enrico Marano ◽  
Cinzia Valeria Russo ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Chronic Migraine ◽  
Idiopathic Intracranial Hypertension ◽  
Dural Sinus
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