Pseudotumor cerebri syndrome: venous sinus obstruction and its treatment with stent placement

Owler, Brian; Parker, Glendon J.; Hálmagyi, G. Michael; Dunne, Victoria G.; Grinnell, Verity; McDowell, David; Besser, Michael

doi:10.3171/jns.2003.98.5.1045

Cited by 194 publications

(125 citation statements)

References 30 publications

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“…4,6,29,34 The mean age of the 31 patients was 32.4 years (range 6-63 years), and 23 (74.2%) were female. Average followup was 48.3 months (range 1-153.6 months).…”

Section: Ventriculoperitoneal Shuntsmentioning

confidence: 99%

“…Only 17 cases, followed up for an average of 11.8 months (range 5-24 months), met the inclusion criteria. 18,19,34,36 Indications for surgery included both headache and vision problems in 12 cases (70.6%), vision problems only in 1 case (5.9%), and headache in 4 (23.5%). The average age was 30 years with a range of 15-52 years.…”

Section: Intracranial Venous Sinus Stentsmentioning

confidence: 99%

“…17,23,42 Based upon the concept that there is functional or actual stenosis of the intracranial venous outflow, intravascular stenting of the venous sinuses has been advocated as a yet another mode of treatment. 4,10,14,[18][19][20]24,33,34,36 Primary indications for the treatment of IIH are intractable headache and vision loss. Unfortunately, there are no evidence-based studies in which the risks and benefits of various interventions are assessed.…”

mentioning

confidence: 99%

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Visual outcomes comparing surgical techniques for management of severe idiopathic intracranial hypertension

Feldon¹

2007

Neurosurgical FOCUS

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Object. The object of this study was to compare surgical techniques for management of visual loss in idiopathic intracranial hypertension (IIH) unresponsive to medical treatment.Methods. The published literature was reviewed using electronic and manual search techniques. Articles were categorized based upon the surgical procedure performed, including optic nerve sheath decompression (ONSD), also called optic nerve sheath fenestration; intracranial venous sinus stent placement; ventriculoperitoneal (VP) shunt placement; and lumboperitoneal (LP) shunt placement. Demographic data and visual outcome of the cumulative experience were compiled and compared for each type of surgical intervention.Results. Seventeen patients treated by stent placement, 31 by VP shunt placement, 44 by LP shunt placement, and 252 patients by ONSD were identified in the literature; average follow-up ranged from 11.8 months for patients treated with stents to 57.2 months for those treated with LP shunts. Improved or resolved vision deficit was noted in 38.7% of patients after VP shunt placement, 47% of patients after stent placement, 44.6% of patients after LP shunt placement, and 80% of eyes after ONSD. Visual worsening was rare for all procedures evaluated.Conclusions. There is a paucity of information regarding visual outcomes from intracranial venous stent placement and cerebrospinal fluid diversion procedures. Visual outcomes from ONSD are better documented and appear to be superior to other surgical techniques for management of IIH. Further studies with improved data collection regarding visual outcomes are needed for surgical procedures other than ONSD in order to assess their possible value as treatments for visual loss in IIH.

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“…4,6,29,34 The mean age of the 31 patients was 32.4 years (range 6-63 years), and 23 (74.2%) were female. Average followup was 48.3 months (range 1-153.6 months).…”

Section: Ventriculoperitoneal Shuntsmentioning

confidence: 99%

Section: Intracranial Venous Sinus Stentsmentioning

confidence: 99%

mentioning

confidence: 99%

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Visual outcomes comparing surgical techniques for management of severe idiopathic intracranial hypertension

Feldon¹

2007

Neurosurgical FOCUS

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“…by the fact that stent angioplasty can help control intracranial hypertension (IH) in some patients 33,34,[42][43][44] . However, lowering the intracranial pressure can result in normalization of venous morphology, suggesting TS stenosis might be induced by IH itself (secondary cranial venous outflow obstruction (CVOO)) 36,37 .…”

Section: Cross Sectional Mri/ Ct Findings In Iihmentioning

confidence: 99%

Idiopathic Intracranial Hypertension: Diagnostic Accuracy of the Transverse Dural Venous Sinus Attenuation on CT Scans

et al. 2014

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SUMMARY -Idiopathic intracranial hypertension (IIH) is a clinical disorder of unknown etiology. It may exhibit several non-specific imaging findings. We observed that patients with intracranial hypertension demonstrate intracranial venous sinus attenuation with changes in the contour and caliber of the distal transverse sinus. This can be seen on routine non-contrast sagittal reformatted CT images of the brain. We have termed this the venous attenuation sign (VAS). This study evaluated the VAS as a marker for IIH assessing the transverse sinuses on sagittal reformatted non-contrast CT for the presence of a VAS in 25 patients with IIH and 24 control patients. Scans were independently assessed in a blinded fashion by three readers. The readers identified the VAS

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“…Based upon recent studies 2 , we have focused on the diagnosis and treatment of pseudotumor cerebri from the point of view of the alterations in the venous drainage of the brain.…”

Section: Introductionmentioning

confidence: 99%

Pseudotumor Cerebri: A New Door Opens for Treatment

et al. 2007

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Pseudotumor cerebri remains a scarcely known pathology. We present the experience of a multidisciplinary working group which studied this disorder focusing on the venous alterations of the dural sinuses. Seventeen cases were studied, diagnosed, controlled and treated by our team. In one of the cases, we placed a stent in the left lateral sinus with good result. In all the patients we observed various degrees of stenosis in the brain venous sinuses quantified by pressure measurement. Nevertheless, to determine the exact cause of this pathology, more studies are necessary.

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Pseudotumor cerebri syndrome: venous sinus obstruction and its treatment with stent placement

Cited by 194 publications

References 30 publications

Visual outcomes comparing surgical techniques for management of severe idiopathic intracranial hypertension

Visual outcomes comparing surgical techniques for management of severe idiopathic intracranial hypertension

Idiopathic Intracranial Hypertension: Diagnostic Accuracy of the Transverse Dural Venous Sinus Attenuation on CT Scans

Pseudotumor Cerebri: A New Door Opens for Treatment

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