| Dural sinus stent placement for idiopathic intracranial hypertension. | |
| | |
MedLine Citation:
|
PMID: 22149379 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Object The use of unilateral dural sinus stent placement in patients with idiopathic intracranial hypertension (IIH) has been described by multiple investigators. To date there is a paucity of information on the angiographic and hemodynamic outcome of these procedures. The object of this study was to define the clinical, angiographic, and hemodynamic outcome of placement of unilateral dural sinus stents to treat intracranial venous hypertension in a subgroup of patients meeting the diagnostic criteria for IIH. Methods Eighteen consecutive patients with a clinical diagnosis of IIH were treated with unilateral stent placement in the transverse-sigmoid junction region. All patients had papilledema. All 12 female patients had headaches; 1 of 6 males had headaches previously that disappeared after weight loss. Seventeen patients had elevated opening pressures at lumbar puncture. Twelve patients had opening pressures of 33-55 cm H(2)O. All patients underwent diagnostic cerebral arteriography that showed venous outflow compromise by filling defects in the transverse-sigmoid junction region. All patients underwent intracranial selective venous pressure measurements across the filling defects. Follow-up arteriography was performed in 16 patients and follow-up venography/venous pressure measurements were performed in 15 patients. Results Initial pressure gradients across the filling defects ranged from 10.5 to 39 mm Hg. Nineteen stent procedures were performed in 18 patients. One patient underwent repeat stent placement for hemodynamic failure. Pressure gradients were reduced in every instance and ranged from 0 to 7 mm Hg after stenting. Fifteen of 16 patients in whom ophthalmological follow-up was performed experienced disappearance of papilledema. Follow-up arteriography in 16 patients at 5-99 months (mean 25.3 months, median 18.5 months) showed patency of all stents without in-stent restenosis. Two patients had filling defects immediately above the stent. Four other patients developed transverse sinus narrowing above the stent without filling defects. One of these patients underwent repeat stent placement because of hemodynamic deterioration. Two of the other 3 patients had hemodynamic deterioration with recurrent pressure gradients of 10.5 and 18 mm Hg. Conclusions All stents remained patent without restenosis. Stent placement is durable and successfully eliminates papilledema in appropriately selected patients. Continuing hemodynamic success in this series was 80%, and was 87% with repeat stent placement in 1 patient. |
| | |
Authors:
|
David A Kumpe; Jeffrey L Bennett; Joshua Seinfeld; Victoria S Pelak; Ashish Chawla; Mary Tierney |
Related Documents
:
|
20695899 - Is the abundance of faecalibacterium prausnitzii relevant to crohn's disease? 843139 - Enterocolitis with peritonitis in a child with pheochromocytoma. 17903939 - Cerebral venous sinus thrombosis in a patient with ulcerative colitis. 21906349 - Plasma proteomic profile of sulfur mustard exposed lung diseases patients using 2-dimen... 22589579 - Sputum eosinophilia can predict responsiveness to inhaled corticosteroid treatment in p... 7834999 - Intraluminal colonic release of immunoreactive tumour necrosis factor in chronic ulcera... 21445609 - Pulmonary vascular disease in gaucher disease: clinical spectrum, determinants of pheno... 2240499 - Spinal catheter anaesthesia for caesarean section in a patient with spina bifida. 7979929 - Reduction of knee torques and leg-related functional abilities in hereditary motor and ... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-12-9 |
Journal Detail:
|
Title: Journal of neurosurgery Volume: - ISSN: 1933-0693 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
|
Created Date: 2011-12-13 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Departments of Radiology. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A novel method of intracranial injection via the postglenoid foramen for brain tumor mouse models.
Next Document: The efficacy of superficial temporal artery-middle cerebral artery anastomosis in patients with moya...