Percutaneous endovascular biopsy in the diagnosis of venous sinus lesions: technical note

J Neurosurg. 2018 Aug 24;131(2):462-466. doi: 10.3171/2018.3.JNS173143. Print 2019 Aug 1.

Abstract

Intracranial hypertension (IH) may be misdiagnosed owing to the lack of typical imaging features and pathological confirmation of the sinus lesions. The authors report the use of percutaneous endovascular biopsy (PEB) for the diagnosis of IH in patients with venous sinus lesions. A total of 9 patients (age 46 ± 9 years) underwent PEB between June 2016 and August 2017. All patients underwent lumbar puncture and contrast-enhanced MRI before the procedure. PEB was technically successful in 6 patients. No intra- or postprocedural complications occurred. The confirmed lesions were meningioma in 2 patients and fibrous thrombus in 4 patients. All patients received individualized treatment. PEB of venous sinus lesions is a safe and efficient method to establish an early diagnosis and appropriate treatment in patients with IH.

Keywords: DAVF = dural arteriovenous fistula; ICP = intracranial pressure; IH = intracranial hypertension; IIH = idiopathic IH; MRBTI = magnetic resonance black-blood thrombus imaging; MRV = magnetic resonance venography; PEB = percutaneous endovascular biopsy; angiography; diagnostic technique; endovascular biopsy; intracranial hypertension; pathology; vascular disorders.

Publication types

  • Case Reports
  • Technical Report

MeSH terms

  • Adult
  • Aged
  • Angiography, Digital Subtraction / methods*
  • Cohort Studies
  • Cranial Sinuses / diagnostic imaging*
  • Cranial Sinuses / surgery*
  • Endovascular Procedures / methods*
  • Female
  • Humans
  • Intracranial Hypertension / diagnostic imaging*
  • Intracranial Hypertension / surgery*
  • Male
  • Middle Aged