Stenting and angioplasty for idiopathic intracranial hypertension: a case series with clinical, angiographic, ophthalmological, complication, and pressure reporting

J Neuroimaging. Jan-Feb 2015;25(1):72-80. doi: 10.1111/jon.12072.

Abstract

Background: Previous studies have demonstrated that cerebral dural sinus stenosis (DSS) may be a potential patho-physiological cause of idiopathic intracranial hypertension (IIH). Endovascular therapy for DSS is emerging as a potential alternative to treat IIH. Here, we present the results of our case series.

Method: We prospectively collected angiographic and manometric data on patients that underwent angioplasty/stenting for IIH. All patients had failed maximal medical therapy (MMT) and had confirmed sinus stenosis. Demographic, clinical and radiological presentation, and outcomes were collected retrospectively.

Results: A total of 18 patients underwent 25 procedures. Demographics revealed a mean age of 30 (range 15-59), 83% (15/18) were female, 72% (13/18) were white, and mean body mass index of 36 (range 23-59.2). All patients presented with classic IIH. Symptom improvement or resolution was reported in 94% (17/18) of patients. All patients had resolution and/or stabilization/improvement of their papilledema. Headaches related to increased pressure improved in 56% (10/18). Re-stenosis and retreatment occurred in 33% (6/18). No procedural related complications were reported.

Conclusion: Dural sinus angioplasty and stenting is relatively safe, feasible, and clinically efficacious for patients with symptomatic sinus stenosis who have failed standard therapy. The long-term durability of patency and clinical improvement remains unknown.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angioplasty / instrumentation
  • Angioplasty / methods*
  • Blood Vessel Prosthesis*
  • Cerebral Angiography
  • Combined Modality Therapy / instrumentation
  • Combined Modality Therapy / methods
  • Female
  • Humans
  • Intracranial Hypertension / diagnosis
  • Intracranial Hypertension / therapy*
  • Intracranial Pressure
  • Male
  • Middle Aged
  • Pseudotumor Cerebri / complications
  • Pseudotumor Cerebri / therapy*
  • Stents*
  • Treatment Outcome
  • Vision Disorders / etiology
  • Vision Disorders / prevention & control*
  • Young Adult