Endovascular Stenting for Idiopathic Intracranial Hypertension

• Main Authors: Faizan Khan, Dana Iancu
• Format: Article
• Language: English
• Published: University of Ottawa 2014-11-01
• Series: University of Ottawa Journal of Medicine
• Subjects: idiopathic intracranial hypertension (IIH); transverse sinus stenosis (TSS); endovascular; stent; intracranial pressure (ICP); headache
• Online Access: https://uottawa.scholarsportal.info/ottawa/index.php/uojm-jmuo/article/view/1045

Transverse sinus stenosis (TSS) is often observed in patients with idiopathic intracranial hypertension (IIH). Studies show that all symptoms of IIH can be resolved by transverse sinus stent placement. We present a case of a 39-year-old woman diagnosed with IIH presented with papilledema and severe headaches. The consideration of interventional management was necessitated by the preceding failure of several months of medical treatment. Her vascular imaging demonstrated stenosis of the transverse sinus and her intracranial venous pressure measurements indicated elevated pressure with a high pressure gradient across the stenosis. She underwent transverse sinus stent placement across the stenotic segment. After this intervention, her symptoms improved and her intracranial pressure normalized. The imaging follow-up revealed efficacious patency of the stent. Based on a mathematical model, we suggest that a Starling-like resistor demonstrating a collapsible transverse sinus can permanently be replaced by a rigid-walled sinus upon employment of an endovascular stent in the stenotic transverse sinus, which should be considered as an alternative to other surgical procedures for IIH patients.