Venous sinus stenting for idiopathic intracranial hypertension

A review of the literature

Ross C. Puffer, Wessam Mustafa, Giuseppe Lanzino

Research output: Contribution to journalReview article

73 Citations (Scopus)

Abstract

Idiopathic intracranial hypertension (IIH) is characterized by headache, papilledema, visual field changes and tinnitus with elevated cerebral spinal fluid opening pressures on lumbar puncture. Left untreated, this condition can lead to permanent visual loss. Previous treatment modalities include medical management, therapeutic lumbar puncture and optic nerve sheath fenestration. They have proved to be effective but carry high rates of symptom recurrence or procedural complications. Focal dural venous sinus stenoses have been identified in many patients with IIH, leading to development of treatment through venous sinus angioplasty and stenting. A review of the literature was performed which identified patients with IIH treated with venous sinus stenting. The procedural data and outcomes are presented. A total of 143 patients with IIH (87% women, mean age 41.4 years, mean body mass index 31.6 kg/m2) treated with venous sinus stenting were included in the analysis. Symptoms at initial presentation included headache (90%), papilledema (89%), visual changes (62%) and pulsatile tinnitus (48%). There was a technical success rate of 99% for the stent placement procedure with a total of nine complications (6%). At follow-up (mean 22.3 months), 88% of patients experienced improvement in headache, 97% demonstrated improvement or resolution of papilledema, 87% experienced improvement or resolution of visual symptoms and 93% had resolution of pulsatile tinnitus. In patients with IIH with focal venous sinus stenosis, endovascular stent placement across the stenotic sinus region represents an effective treatment strategy with a high technical success rate and decreased rate of complications compared with treatment modalities currently used.

Original languageEnglish (US)
Pages (from-to)483-486
Number of pages4
JournalJournal of NeuroInterventional Surgery
Volume5
Issue number5
DOIs
StatePublished - Sep 2013

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Pseudotumor Cerebri
Papilledema
Tinnitus
Headache
Spinal Puncture
Stents
Pathologic Constriction
Cerebrospinal Fluid Pressure
Therapeutics
Optic Nerve
Visual Fields
Angioplasty
Body Mass Index
Recurrence

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Venous sinus stenting for idiopathic intracranial hypertension : A review of the literature. / Puffer, Ross C.; Mustafa, Wessam; Lanzino, Giuseppe.

In: Journal of NeuroInterventional Surgery, Vol. 5, No. 5, 09.2013, p. 483-486.

Research output: Contribution to journalReview article

Puffer, Ross C. ; Mustafa, Wessam ; Lanzino, Giuseppe. / Venous sinus stenting for idiopathic intracranial hypertension : A review of the literature. In: Journal of NeuroInterventional Surgery. 2013 ; Vol. 5, No. 5. pp. 483-486.
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