Venous sinus pulsatility and the potential role of dural incompetence in idiopathic intracranial hypertension.
نویسندگان
چکیده
BACKGROUND Idiopathic intracranial hypertension (IIH) remains a poorly understood and therapeutically challenging disease. Enthusiasm has emerged for endovascular therapy with stent reconstruction of dural sinus narrowing; however, a complete understanding of the hydrodynamic dysequilibrium is lacking. OBJECTIVE To review and characterize catheter manometry findings including pulsatility changes within the venous sinuses in IIH. METHODS Cases of venous sinus stent implantation for IIH were retrospectively reviewed. RESULTS Three cases of venous sinus stent implantation for treatment of IIH are reported. All cases demonstrated severe narrowing (>70%) within the transverse sinus and a high pressure gradient across the lesion (>30 mm Hg). Stent implantation resulted in pulsatility attenuation, correction of pressure gradient, and improvement of flow. CONCLUSION We report the finding of high venous sinus pulsatility attenuation after stent implantation for dural sinus narrowing and propose the hypothesis that this finding is a marker of advanced dural sinus incompetence. This characteristic may be useful in identifying patients who would benefit from endovascular stent remodeling.
منابع مشابه
Dural Venous Sinus Angioplasty and Stenting for Treatment of Idiopathic Intracranial Hypertension
BACKGROUND Lumboperitoneal shunt (LPS), ventriculoperitoneal shunt (VPS) and optic nerve sheath fenestration (ONSF) are accepted surgical therapies for medically refractory idiopathic intracranial hypertension (IIH). In the subset of patients with IIH and venous sinus stenosis, dural venous sinus stenting has emerged as an alternative surgical approach. METHODS All cases of dural stents for I...
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عنوان ژورنال:
- Neurosurgery
دوره 71 4 شماره
صفحات -
تاریخ انتشار 2012