CEREBRAL VENOUS SINUS STENTING FOR RESISTANT IDIOPATHIC INTRACRANIAL HYPERTENSION (IIH), AN EXPERIENCE ON 15 PATIENTS

Authors

Milad Hospital

10.22034/icrj.2022.173675

Abstract

Objectives:
Transverse sinus stenosis is common in patients with Idiopathic Intracranial Hypertension (IIH). While the role of transverse sinus stenosis in the pathogenesis of IIH remains controversial, some studies have shown that placement of a stent in a narrow transverse sinus can reduce intravenous pressure and improve symptoms. In this study, we aim to further clarify the hypothesis that the signs and symptoms of IIH can be relieved or improved by placing a stent in the transverse sinus stenosis.
Methods:
Fifteen patients with IIH (All Female) who had not responded to conventional treatments were selected. Cerebral venous sinus stenting (CVSS), which involves accessing the stenotic area by applying the sheath and guidewire and placing the stent was performed. Our investigation focused on the important and determining factors in the diagnosis and pathogenesis of this disease including: Intracranial and intravenous sinus pressure, optic disc edema, visual field defects and headaches both before and after the placement of the stent in the transverse sinus of the patients. Patients were followed up for approximately 21 months post-procedure.
Results:
Four (26.7%) patients showed continued headaches. The visual disturbance was completely resolved in 13 (86.7%) patients as well as complete resolution of papilledema in 13 (86.7%), and partially in 2 (13.3%) patients. The intracranial pressure decreased in all patients and 2 (13.3%) patients continued to have auditory bruit, but no new tinnitus was reported.
Conclusion:
Our findings support the effectiveness of stent placement in the transverse sinus of selected patients with IIH and can be used in certain situations. Our results can prove the safety of this method.