Intra-procedural cerebral sinus thrombosis during endovascular treatment of idiopathic intracranial hypertension

Jorge Arturo Larco, Mehdi Abbasi, Ramanathan Kadirvel, David F. Kallmes, Luis E. Savastano, Waleed Brinjikji

Research output: Contribution to journalArticlepeer-review

Abstract

Stenting of the intracranial venous sinuses has shown promising results in patients who are refractory to medical treatment of idiopathic intracranial hypertension (IIH). Among the reported complications associated with this procedure, in-stent thrombosis is an unreported one. We present a case of cerebral sinus thrombosis during endovascular treatment of IIH. A 33-year-old man with multiple comorbidities was presented with non-specific vision changes and headaches. Initial workup revealed a diagnosis of idiopathic intracranial hypertension which was treated medically but with no improvement. Therefore, cerebral sinus stenting was pursued. During the procedure, an in-stent thrombus was identified which was retrieved mechanically and was sent for histological and immunohistochemical evaluation. The retrieved thrombus was predominantly composed of RBCs (57.8%) followed by fibrin (30.78%), platelet (6.4%), and WBCs (5.95%), with high expression of CitH3 (neutrophil extra cellular traps specific marker) (10.9%), and CD66 (11.35%).

Original languageEnglish (US)
JournalNeuroradiology Journal
DOIs
StateAccepted/In press - 2022

Keywords

  • clot analysis
  • Idiopathic intracranial hypertension
  • intracerebral venous stenting
  • venous thrombosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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