Idiopathic intracranial hypertension with stenosis of a solitary occipital venous sinus treated with stenting. uri icon

Overview

abstract

  • A 47-year-old live kidney-donor woman presented with headaches and blurred vision. Neuro-ophthalmological examination demonstrated papilledema and right eye inferior nasal defect. Brain MRV showed no sinus thrombosis but solitary right venous sinus draining the torcular Herophili to right jugular bulb. Lumbar puncture revealed elevated CSF opening pressure of 40 cm H2O with normal composition. She was diagnosed with idiopathic intracranial hypertension (IIH). She did not tolerate medical management and declined CSF diversion surgery. Cerebral angiography and venography showed venous outflow drainage from torcular Herophili through a solitary occipital sinus which has distal severe stenosis and pressure gradient of 10 mmHg. Balloon angioplasty and stenting of the occipital sinus were performed. Post-stenting, the stenosis and pressure gradient resolved. At 3-months follow-up, her symptoms and papilledema had resolved and CSF opening pressure was normal at 15 cm H2O. Aberrant cerebral venous anatomy may cause IIH and can be treatable with neuroendovascular techniques.

publication date

  • August 5, 2020

Research

keywords

  • Pseudotumor Cerebri
  • Sinus Thrombosis, Intracranial
  • Stents

Identity

PubMed Central ID

  • PMC7645177

Scopus Document Identifier

  • 85089195784

Digital Object Identifier (DOI)

  • 10.1177/1591019920949094

PubMed ID

  • 32757674

Additional Document Info

volume

  • 26

issue

  • 5