Anatomic measurements of cerebral venous sinuses in idiopathic intracranial hypertension patients

BackgroundDural venous sinus stenting has emerged as an effective and durable treatment for idiopathic intracranial hypertension (IIH). Improved visualization of the venous sinuses can improve stent placement.MethodsWe present two cases of IIH treated with venous sinus stenting in which retrograde three-dimensional rotational venography (3DRV) provided superior anatomical details of the venous sinuses for optimal sizing and positioning of stent.ResultsComparison of pre-stent 3DRV with post-stent contrast-enhanced flat panel detector CT allowed confirmation of stent placement and the result of stenosis dilation.ConclusionThis 3DRV technique provides precise visualization of venous sinus stenosis prior to stenting without the need for arterial cerebral angiography during the treatment course.

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Dynamic nature of intracranial venous sinuses in idiopathic intracranial hypertension

Interventional Neuroradiology ◽

10.1177/1591019919871393 ◽

2019 ◽

Vol 26 (1) ◽

pp. 118-120 ◽

Cited By ~ 3

Author(s):

Patrick Nicholson ◽

Stéphanie Lenck ◽

Walter Kucharczyk ◽

Vitor Mendes-Pereira

Keyword(s):

Case Report ◽

Intracranial Hypertension ◽

Medical Therapy ◽

Idiopathic Intracranial Hypertension ◽

Complete Resolution ◽

Transverse Sinus ◽

Venous Sinus ◽

Dynamic Nature ◽

Venous Sinuses ◽

Transverse Sinuses

There is increasing interest in venous sinus stenting in patients with idiopathic intracranial hypertension who are refractory to medical therapy. Often the transverse sinus stenoses are bilateral, however, and there is no clear evidence for whether we should stent one or both sides in these patients. Our practice is to first stent one side, and in this brief case report, we demonstrate complete resolution of the contralateral stenosis in one such patient who underwent stenting. Her symptoms also completely resolved, and so this case highlights the dynamic fluctuant nature of the transverse sinuses.

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Bilateral Transverse Sinus Angioplasty for the Treatment of Idiopathic Intracranial Hypertension – Case Report and Literature Review

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0039-1692122 ◽

2019 ◽

Vol 38 (03) ◽

pp. 203-209 ◽

Cited By ~ 1

Author(s):

Luciano B. Manzato ◽

Paulo Moacir Mesquita Filho ◽

Leonardo Frighetto ◽

Nério Dutra Azambuja ◽

Rafael Cordeiro ◽

...

Keyword(s):

Intracranial Hypertension ◽

Idiopathic Intracranial Hypertension ◽

Transverse Sinus ◽

Venous Sinuses ◽

Nerve Sheath ◽

Sinus Stenosis ◽

The Subject ◽

Bilateral Stenting ◽

Visual Disturbances ◽

Dural Venous Sinuses

AbstractIdiopathic intracranial hypertension (IIH) is a disease characterized by an increase in intracranial pressure, without presence of parenchymal lesions or hydrocephalus that justify it. Over 90% of cases there is association with stenosis of the dural venous sinuses. It is characterized by headache, tinidus, nausea, vomiting and visual disturbances. Initial treatment is clinical and when it fails there is indication of invasive procedures, among them shunts and fenestration of the optic nerve sheath. Angioplasty of dural venous sinuses, when indicated, has shown an alternative with better results and less complications. We report a case of a female patient, with 27 years old, diagnosed with IIH and bilateral transverse sinus stenosis, which was treated by bilateral stenting and total resolution of symptoms. Besides describing the case we review the literature about the subject.

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