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Endovascular stents relieve idiopathic intracranial hypertension
Monday, 29 November 1999 19:00 | 
| Radiology News - Radiology Articles |
Endovascular stent placement can relieve idiopathic intracranial hypertension in patients with venous sinus stenosis, according to a report in the February 19th issue of Neurology.
Endovascular stent placement can relieve idiopathic intracranial hypertension in patients with venous sinus stenosis, according to a report in the February 19th issue of Neurology.
"Lateral sinus stenting shows promise as an alternative treatment to neurosurgical intervention in intractable cases," Dr. Anne Donnet from Timone Hospital, Marseille, France told Reuters Health. "The safety and efficacy of this technique should be evaluated further in larger series with longer follow-up to be definitely validated."
Dr. Donnet and colleagues placed intracranial venous sinus stents in ten consecutive patients with refractory idiopathic intracranial hypertension. All ten had morphological obstruction of the venous lateral sinuses, with pressure gradients between the proximal prestenotic transverse sinus and the distal poststenotic transverse sinus that ranged from 14 to 34 mm Hg, the authors report.
None of the patients had any serious adverse effects after the procedure. Seven had transient headache on the treated side.
After stenting, elevated intrasinus and CSF pressures normalized in all patients. Headaches were completely relieved in six patients, improved in two, and unchanged in two. Papilledema resolved in all ten patients. Visual acuity normalized in four patients and improved in three patients.
Stents were still patent at 12 months after placement, the investigators say.
"As the pathophysiological mechanisms of idiopathic intracranial hypertension are still unknown, this hemodynamic and manometric approach may contribute to a better understanding of the phenomenon that subtends this pathological entity," Dr. Donnet said.
"The strategy of management of idiopathic intracranial hypertension needs clarification, the role of diuretics is uncertain, and which surgical intervention is the most effective and safe is unknown," she concluded. "Prospective trials to examine these issues are urgently needed.
"Lateral sinus stenting shows promise as an alternative treatment to neurosurgical intervention in intractable cases," Dr. Anne Donnet from Timone Hospital, Marseille, France told Reuters Health. "The safety and efficacy of this technique should be evaluated further in larger series with longer follow-up to be definitely validated."
Dr. Donnet and colleagues placed intracranial venous sinus stents in ten consecutive patients with refractory idiopathic intracranial hypertension. All ten had morphological obstruction of the venous lateral sinuses, with pressure gradients between the proximal prestenotic transverse sinus and the distal poststenotic transverse sinus that ranged from 14 to 34 mm Hg, the authors report.
None of the patients had any serious adverse effects after the procedure. Seven had transient headache on the treated side.
After stenting, elevated intrasinus and CSF pressures normalized in all patients. Headaches were completely relieved in six patients, improved in two, and unchanged in two. Papilledema resolved in all ten patients. Visual acuity normalized in four patients and improved in three patients.
Stents were still patent at 12 months after placement, the investigators say.
"As the pathophysiological mechanisms of idiopathic intracranial hypertension are still unknown, this hemodynamic and manometric approach may contribute to a better understanding of the phenomenon that subtends this pathological entity," Dr. Donnet said.
"The strategy of management of idiopathic intracranial hypertension needs clarification, the role of diuretics is uncertain, and which surgical intervention is the most effective and safe is unknown," she concluded. "Prospective trials to examine these issues are urgently needed.
