Idiopathic Intracranial Hypertension Masking as Obstructive Hydrocephalus: A Case Report

Maurer, Robert; Henry, April; Liu, Kenneth C.; Zacharia, Brad E.

doi:10.7759/cureus.4420

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…Following an extensive systematic review, our patient's gradient pressure surpasses all others documented in the literature (Table). 3-52 According to our systematic review, the highest recorded gradient pressure was 67 mm Hg reported by Tschoe et al 36 who highlighted the impact of changes in mean arterial pressure and end-tidal carbon dioxide on venous sinus pressures in patients with IIH undergoing venous sinus stenting. Moreover, Ahmed et al reviewed clinical, venographic, and intracranial pressure data before and after stent placement in transverse sinus stenosis in 52 patients with IIH; the highest pressure gradient they reported was 41 mm Hg.…”

Section: Discussionmentioning

confidence: 82%

Transverse Sinus Stenting for the Treatment of Idiopathic Intracranial Hypertension With a Pressure Gradient of 70 mm Hg: A Technical Note and Systematic Review

Ghanem,

El Naamani,

Rawad

et al. 2023

Operative Neurosurgery

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BACKGROUND AND IMPORTANCE: Venous sinus stenosis is believed to play a role in the pathogenesis of idiopathic intracranial hypertension (IIH). Venous stenting has emerged as a promising treatment option for patients with IIH because of venous sinus stenosis refractory to medical management or unsuitable for shunt placement. In this technical note, we present a case of IIH with the highest recorded pressure gradient to date. CLINICAL PRESENTATION: This technical note presents the successful use of intracranial venous stenting in a patient with IIH because of severe venous sinus stenosis, leading to significant improvement in vision and reduction in intracranial pressure. A meticulous review of the literature revealed that our patient exhibited the highest recorded pressure gradient (70 cm of H2O). This remarkable finding underscores the potential effectiveness of venous stenting as a viable treatment approach. The procedure involved the placement of a Zilver stent (Cook Medical) and balloon angioplasty after stenting of the right transverse sinus stenosis, resulting in a substantial decrease in pressure gradient. Following the procedure, another venous manometry showed no more gradient with a uniform pressure in the whole venous system at 18 cm of H2O. CONCLUSION: To our knowledge, this case presents the highest pressure gradient reported in the literature and contributes to the growing evidence supporting venous stenting in patients with IIH and venous sinus stenosis.

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Section: Discussionmentioning

confidence: 82%

Transverse Sinus Stenting for the Treatment of Idiopathic Intracranial Hypertension With a Pressure Gradient of 70 mm Hg: A Technical Note and Systematic Review

Ghanem,

El Naamani,

Rawad

et al. 2023

Operative Neurosurgery

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“…We found 42 articles with 105 cases: 48 pediatric and 57 adult (71–112), Table 4. The distribution was as follows: hematological diseases (N = 16) (90–93,95–104,106,107), rheumatologic diseases (N = 7): Behçet’s disease and systemic lupus erythematosus (SLE) (71,72,83,94,105,108,109), different genetic diseases (N = 5) (73,74,…”

Section: Resultsmentioning

confidence: 99%

Diagnosis of idiopathic intracranial hypertension - the importance of excluding secondary causes: A systematic review

et al. 2021

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Background Idiopathic intracranial hypertension is characterized by increased intracranial pressure without any pathological findings on neuroimaging, except for signs of high intracranial pressure. Before diagnosing idiopathic intracranial hypertension secondary causes of increased intracranial pressure should be excluded. Objective to characterize the phenotype of patients with secondary intracranial hypertension and to identify possible risk factors for secondary intracranial hypertension. Methods We have systematically searched the PubMed database. The publications were analyzed according to the patient phenotype, age, gender, comorbidities, body mass index/weight status, and additional medication. The results are summarized in four categories: medication, infection, hormonal induced intracranial hypertension and miscellaneous groups of diseases related to sIH. Results We identified 105 eligible papers which included 272 cases. There were 49.6% pediatric cases. Among the adult group,70.9% were women. A total of 40.4% of all cases were obese or overweight, 27% among adults and 13.4% among pediatric cases. Increased BMI and recent weight gain, anemia, renal diseases and hypertension were the most frequent comorbidities related to sIH. Conclusion Among sIH patients, 40.4% were obese or overweight; two thirds were women. We recommend that even patients with a typical IIH phenotype should be screened for secondary causes.

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Idiopathic Intracranial Hypertension Masking as Obstructive Hydrocephalus: A Case Report

Cited by 2 publications

References 19 publications

Transverse Sinus Stenting for the Treatment of Idiopathic Intracranial Hypertension With a Pressure Gradient of 70 mm Hg: A Technical Note and Systematic Review

Transverse Sinus Stenting for the Treatment of Idiopathic Intracranial Hypertension With a Pressure Gradient of 70 mm Hg: A Technical Note and Systematic Review

Diagnosis of idiopathic intracranial hypertension - the importance of excluding secondary causes: A systematic review

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