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Venous sinus pulsatility and the potential role of dural incompetence in idiopathic intracranial hypertension. Neurosurgery 2012 Oct;71(4):877-83

Date

09/20/2012

Pubmed ID

22989961

DOI

10.1227/NEU.0b013e318267a8f9

Scopus ID

2-s2.0-85027951134   15 Citations

Abstract

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.

Author List

Lazzaro MA, Darkhabani Z, Remler BF, Hong SH, Wolfe TJ, Zaidat OO, Fitzsimmons BF

Authors

Sang Hun Hong MD Assistant Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
Marc A. Lazzaro MD Associate Professor in the Neurology department at Medical College of Wisconsin
Bernd F. Remler MD Professor in the Neurology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Angiography, Digital Subtraction
Constriction, Pathologic
Female
Humans
Longitudinal Studies
Magnetic Resonance Angiography
Pseudotumor Cerebri
Retrospective Studies
Stents
Transverse Sinuses
Treatment Outcome
Venous Pressure