Neurointervention.  2018 Sep;13(2):138-143. 10.5469/neuroint.2018.00990.

Endovascular Treatment of Idiopathic Intracranial Hypertension with Stenting of the Transverse Sinus Stenosis

Affiliations
  • 1Department of Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Japan. miyachi.shigeru.752@mail.aichi-med-u.ac.jp
  • 2Department of Neurosurgery and Endovascular Therapy, Osaka Medical College, Takatsuki, Japan.
  • 3Department of Neurosurgery, Ohnishi Neurosurgical Hospital, Akashi, Japan.

Abstract

For many years, the pathophysiology of idiopathic intracranial hypertension (IIH) was interpreted as "secondary intracranial hypertension," and IIH was considered to be caused by brain edema due to obstructive sleep apnea. Another theory proposed cerebrospinal fluid (CSF) absorption impairment due to excessive medication with vitamin A derivatives. Other reports pointed out the importance of obesity, which may cause an impairment of intracranial venous drainage due to elevated right atrial pressure. Patients with medically refractory IIH have traditionally undergone a CSF diversion. Venous outlet impairment on IIH has recently been reported as a causative or contributory cause, and thus focused venoplasty of the stenotic sinus with a stent has emerged as a new treatment strategy. We report the cases of two patients who presented with headache and papilledema with IIH. They successfully underwent stent placement at the stenosis of the transverse sinus and experienced complete resolution of symptoms.

Keyword

Idiopathic intracranial hypertension; Transvers sinus; Stenting

MeSH Terms

Absorption
Atrial Pressure
Brain Edema
Cerebrospinal Fluid
Constriction, Pathologic*
Drainage
Headache
Humans
Obesity
Papilledema
Pseudotumor Cerebri*
Sleep Apnea, Obstructive
Stents*
Vitamin A
Vitamin A
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