Intracranial venous sinus stenting for benign intracranial hypertension: Clinical indications, technique, and preliminary results

Felipe C. Albuquerque, Shervin R. Dashti, Yin C. Hu, C. Benjamin Newman, Mohamed Teleb, Cameron McDougall, Harold L. Rekate

Research output: Contribution to journalReview article

Abstract

Objective: The cause of pseudotumor cerebri, or benign intracranial hypertension (BIH), is controversial. We report our results from 18 cases of venous sinus stenting (VSS), the largest series in the literature, with specific focus on the rate of technical success, amelioration of the subjective symptom of headache, attendant complications, and radiographic patency on follow-up. Methods: Review of our prospectively maintained database identified 18 patients who had undergone 19 VSS procedures for the placement of 30 stents in the past 2.5 years. Indications for treatment included a clinical diagnosis of BIH with venographic demonstration of stenosis. Results: VSS was technically successful in all patients (100%). No patient suffered a permanent complication. Three patients were lost to follow-up. The remaining 15 patients were followed clinically and asked to rate their headache severity on a scale of 1 to 10 both before and after VSS. Overall, 12 patients (80%) qualified their headaches as better after VSS, two stated that they were the same, and one patient said that they were worse. Of 14 patients who underwent follow-up angiography, all demonstrated normal patency of the stented segments. In one of these patients, stenosis was detected on follow-up in the unstented segment of the sigmoid sinus and jugular bulb. Conclusions: VSS is highly effective (80%) in ameliorating headache associated with BIH. The procedure is associated with a high rate of technical success (100%), a low rate of permanent complications (0), and a high rate of stent patency on follow-up angiography (100%).

Original languageEnglish (US)
Pages (from-to)648-652
Number of pages5
JournalWorld Neurosurgery
Volume75
Issue number5-6
DOIs
StatePublished - May 1 2011
Externally publishedYes

Fingerprint

Cranial Sinuses
Pseudotumor Cerebri
Headache
Stents
Angiography
Pathologic Constriction
Lost to Follow-Up
Sigmoid Colon
Neck

Keywords

  • Benign intracranial hypertension
  • Intracranial venous sinus stent

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Intracranial venous sinus stenting for benign intracranial hypertension : Clinical indications, technique, and preliminary results. / Albuquerque, Felipe C.; Dashti, Shervin R.; Hu, Yin C.; Newman, C. Benjamin; Teleb, Mohamed; McDougall, Cameron; Rekate, Harold L.

In: World Neurosurgery, Vol. 75, No. 5-6, 01.05.2011, p. 648-652.

Research output: Contribution to journalReview article

Albuquerque, Felipe C. ; Dashti, Shervin R. ; Hu, Yin C. ; Newman, C. Benjamin ; Teleb, Mohamed ; McDougall, Cameron ; Rekate, Harold L. / Intracranial venous sinus stenting for benign intracranial hypertension : Clinical indications, technique, and preliminary results. In: World Neurosurgery. 2011 ; Vol. 75, No. 5-6. pp. 648-652.
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abstract = "Objective: The cause of pseudotumor cerebri, or benign intracranial hypertension (BIH), is controversial. We report our results from 18 cases of venous sinus stenting (VSS), the largest series in the literature, with specific focus on the rate of technical success, amelioration of the subjective symptom of headache, attendant complications, and radiographic patency on follow-up. Methods: Review of our prospectively maintained database identified 18 patients who had undergone 19 VSS procedures for the placement of 30 stents in the past 2.5 years. Indications for treatment included a clinical diagnosis of BIH with venographic demonstration of stenosis. Results: VSS was technically successful in all patients (100{\%}). No patient suffered a permanent complication. Three patients were lost to follow-up. The remaining 15 patients were followed clinically and asked to rate their headache severity on a scale of 1 to 10 both before and after VSS. Overall, 12 patients (80{\%}) qualified their headaches as better after VSS, two stated that they were the same, and one patient said that they were worse. Of 14 patients who underwent follow-up angiography, all demonstrated normal patency of the stented segments. In one of these patients, stenosis was detected on follow-up in the unstented segment of the sigmoid sinus and jugular bulb. Conclusions: VSS is highly effective (80{\%}) in ameliorating headache associated with BIH. The procedure is associated with a high rate of technical success (100{\%}), a low rate of permanent complications (0), and a high rate of stent patency on follow-up angiography (100{\%}).",
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T2 - Clinical indications, technique, and preliminary results

AU - Albuquerque, Felipe C.

AU - Dashti, Shervin R.

AU - Hu, Yin C.

AU - Newman, C. Benjamin

AU - Teleb, Mohamed

AU - McDougall, Cameron

AU - Rekate, Harold L.

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N2 - Objective: The cause of pseudotumor cerebri, or benign intracranial hypertension (BIH), is controversial. We report our results from 18 cases of venous sinus stenting (VSS), the largest series in the literature, with specific focus on the rate of technical success, amelioration of the subjective symptom of headache, attendant complications, and radiographic patency on follow-up. Methods: Review of our prospectively maintained database identified 18 patients who had undergone 19 VSS procedures for the placement of 30 stents in the past 2.5 years. Indications for treatment included a clinical diagnosis of BIH with venographic demonstration of stenosis. Results: VSS was technically successful in all patients (100%). No patient suffered a permanent complication. Three patients were lost to follow-up. The remaining 15 patients were followed clinically and asked to rate their headache severity on a scale of 1 to 10 both before and after VSS. Overall, 12 patients (80%) qualified their headaches as better after VSS, two stated that they were the same, and one patient said that they were worse. Of 14 patients who underwent follow-up angiography, all demonstrated normal patency of the stented segments. In one of these patients, stenosis was detected on follow-up in the unstented segment of the sigmoid sinus and jugular bulb. Conclusions: VSS is highly effective (80%) in ameliorating headache associated with BIH. The procedure is associated with a high rate of technical success (100%), a low rate of permanent complications (0), and a high rate of stent patency on follow-up angiography (100%).

AB - Objective: The cause of pseudotumor cerebri, or benign intracranial hypertension (BIH), is controversial. We report our results from 18 cases of venous sinus stenting (VSS), the largest series in the literature, with specific focus on the rate of technical success, amelioration of the subjective symptom of headache, attendant complications, and radiographic patency on follow-up. Methods: Review of our prospectively maintained database identified 18 patients who had undergone 19 VSS procedures for the placement of 30 stents in the past 2.5 years. Indications for treatment included a clinical diagnosis of BIH with venographic demonstration of stenosis. Results: VSS was technically successful in all patients (100%). No patient suffered a permanent complication. Three patients were lost to follow-up. The remaining 15 patients were followed clinically and asked to rate their headache severity on a scale of 1 to 10 both before and after VSS. Overall, 12 patients (80%) qualified their headaches as better after VSS, two stated that they were the same, and one patient said that they were worse. Of 14 patients who underwent follow-up angiography, all demonstrated normal patency of the stented segments. In one of these patients, stenosis was detected on follow-up in the unstented segment of the sigmoid sinus and jugular bulb. Conclusions: VSS is highly effective (80%) in ameliorating headache associated with BIH. The procedure is associated with a high rate of technical success (100%), a low rate of permanent complications (0), and a high rate of stent patency on follow-up angiography (100%).

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