Document Detail


Efficacy of endovascular stenting in dural venous sinus stenosis for the treatment of idiopathic intracranial hypertension.
MedLine Citation:
PMID:  19877792     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Multiple pathophysiological mechanisms have been proposed for the increased intracranial pressure observed in idiopathic intracranial hypertension (IIH). The condition is well characterized, with intractable headaches, visual obscurations, and papilledema as dominant features, mainly affecting obese women. With the advent of MR venography and increased use of cerebral angiography, there has been recent emphasis on the significant number of patients with IIH found to have associated nonthrombotic dural venous sinus stenosis. This has led to a renewed interest in endovascular stenting as a treatment for IIH. However, the assumption that venous stenosis leads to a high pressure gradient that decreases CSF resorption through arachnoid villi requires further evidence. In this paper, the authors analyze the published results to date of dural venous sinus stenting in patients with IIH. They also present a case from their institution for illustration. The pathophysiological mechanism in IIH requires further elucidation, but venous sinus stenosis with subsequent intracranial hypertension appears to be an important mechanism in at least a subgroup of patients with IIH. Among these patients, 78% had complete relief or improvement of their main presenting symptoms after endovascular stenting. Resolution or improvement in papilledema was seen in 85.1% of patients. Endovascular stenting should be considered whenever venous sinus stenosis is diagnosed in patients with IIH.
Authors:
Ahmet Arac; Marco Lee; Gary K Steinberg; Mary Marcellus; Michael P Marks
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgical focus     Volume:  27     ISSN:  1092-0684     ISO Abbreviation:  Neurosurg Focus     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-02     Completed Date:  2009-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896471     Medline TA:  Neurosurg Focus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E14     Citation Subset:  IM    
Affiliation:
Departments of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Female
Humans
Obesity
Pseudotumor Cerebri / surgery*
Sinus Thrombosis, Intracranial
Stents*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Endovascular embolization with Onyx in the management of sinus pericranii: a case report.
Next Document:  The diploic venous system: surgical anatomy and neurosurgical implications.