Neuroendovascular Cerebral Sinus Stenting in Idiopathic Intracranial Hypertension

Fawaz Al-Mufti; Vincent Dodson; Krishna Amuluru; Jessy Walia; Ethan Wajswol; Rolla Nuoman; Irwin A Keller; Steven Schonfeld; Sudipta Roychowdhury; Gaurav Gupta

doi:10.1159/000500051

Neuroendovascular Cerebral Sinus Stenting in Idiopathic Intracranial Hypertension

Interv Neurol. 2020 Jan;8(2-6):164-171. doi: 10.1159/000500051. Epub 2019 Jun 4.

Authors

Fawaz Al-Mufti^{1

2

3}, Vincent Dodson³, Krishna Amuluru^{3

4}, Jessy Walia⁵, Ethan Wajswol³, Rolla Nuoman⁵, Irwin A Keller⁶, Steven Schonfeld⁶, Sudipta Roychowdhury⁶, Gaurav Gupta⁷

Affiliations

¹ Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, New York, USA.
² Department of Neurology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA.
³ Department of Neurosurgery, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA.
⁴ Department of Neurointerventional Radiology, University of Pittsburgh, Hamot, Erie, Pennsylvania, USA.
⁵ Department of Neurology, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA.
⁶ Department of Radiology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA.
⁷ Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA.

Abstract

Idiopathic intracranial hypertension (IIH) is a rare, ill-understood disease of significant morbidity. Because the pathophysiology is poorly understood, treatment protocols are not uniform and are directed towards alleviating the most common symptoms: headache and visual loss. In this review, we analyze 25 case series, all of which included IIH patients (n = 408) who were treated with placement of a venous sinus stent. Among 342 patients who had headache, 240 patients (70.2%) had improvement or resolution of headache after the stent insertion. Of the 217 patients documented to have visual problems, visual acuity was improved or stabilized in 161 patients (74.2%). Of the 304 patients with papilledema, 257 showed resolution or improved (84.5%). Of the 124 patients who presented with pulsatile tinnitus, it was resolved in 110 patients (88.7%) after stent placement. Endovascular management of dural sinus stenosis is therefore clinically efficacious in patients with IIH who have failed medical and surgical therapy.

Keywords: Headache; Idiopathic intracranial hypertension; Venous sinus stent; Visual loss.

Publication types

Review