Transverse Sinus Stenting for Pseudotumor Cerebri: A Cost Comparison with CSF Shunting

Ahmed, Rebekah M.; Zmudzki, Fredrick; Parker, Geoff; Owler, Brian; Hálmagyi, G. Michael

doi:10.3174/ajnr.a3806

Cited by 49 publications

(27 citation statements)

References 22 publications

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“…These results appear much more favorable than those reported for shunting in IIH in which there is a 75% failure rate at 2 years for VP shunts and an 86% failure rate at 18 months for LP shunts [5]. Along these lines, Ahmed et al [33] recently conducted a cost analysis for shunting versus venous sinus stenting in the treatment of IIH, and found that venous stenting significantly reduced the cost per 100 procedures compared with shunting. Although the cost of each individual procedure was similar, the additional cost resulted from a far greater number of shunt procedures performed per patient.…”

Section: Discussionmentioning

confidence: 65%

Venous sinus stenting is a valuable treatment for fulminant idiopathic intracranial hypertension

Elder

Goodwin

Kosztowski

et al. 2015

Journal of Clinical Neuroscience

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Section: Discussionmentioning

confidence: 65%

Venous sinus stenting is a valuable treatment for fulminant idiopathic intracranial hypertension

Elder

Goodwin

Kosztowski

et al. 2015

Journal of Clinical Neuroscience

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“…Ahmed et al 53 reported that in their health care system in Australia, the cost of the initial dural venous sinus stent placement was similar to the cost of the initial CSF flow-diversion procedure; however, when one took into account the cost of revisions, the total cost of CSF flow diversion was 5 times higher. Although CSF flow diversion is commonly performed, the literature regarding outcomes and high rates of revision does not compare favorably with recent data on venous sinus stent placement when using strict patient selection, dual antiplatelet therapy, and modern devices.…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of CSF Diversion Procedures and Dural Venous Sinus Stenting in the Setting of Medically Refractory Idiopathic Intracranial Hypertension

Satti

Leishangthem

Chaudry

2015

AJNR Am J Neuroradiol

178

184

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BACKGROUND AND PURPOSE:In medically refractory idiopathic intracranial hypertension, optic nerve sheath fenestration or CSF shunting is considered the next line of management. Venous sinus stenosis has been increasingly recognized as a treatable cause of elevated intracranial pressure in a subset of patients. In this article, we present the results of the largest meta-analysis of optic nerve sheath fenestration, CSF shunting, and dural venous sinus stenting. This is the only article that compares these procedures, to our knowledge.

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“…97,98,101,102,107 -109 Intracranial MR or CT venograms are performed to exclude dural sinus thrombosis or stenosis. In cases that are positive for either venous sinus thrombosis or stenosis, it is unclear as to whether the increased intracranial pressure resulted in compression of the dural venous sinuses leading to these findings, or if the thrombosis or stenosis led to impaired CSF resorption and increased pressure 98,99,110 (Fig. 13).…”

Section: Idiopathic Intracranial Hypertensionmentioning

confidence: 97%

MRI in the Evaluation of Acute Visual Syndromes

Mukhi

Lincoln²

2015

Topics in Magnetic Resonance Imaging

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Acute visual symptom emergencies occur commonly and present a challenge to both clinical and radiologic facets. Although most patients with visual complaints routinely require clinical evaluation with direct ophthalmologic evaluation, imaging is rarely necessary. However, there are highly morbid conditions where the prompt recognition and management of an acute visual syndrome (AVS) requires an astute physician to probe further. Suspicious symptomatology including abrupt visual loss, diplopia, ophthalmoplegia, and proptosis/exophthalmos require further investigation with advanced imaging modalities such as magnetic resonance imaging and magnetic resonance angiography. This review will discuss a variety of AVSs including orbital apex syndrome, cavernous sinus thrombosis, cavernous carotid fistula, acute hypertensive encephalopathy (posterior reversible encephalopathy syndrome), optic neuritis, pituitary apoplexy including hemorrhage into an existing adenoma, and idiopathic intracranial hypertension. A discussion of each entity will focus on the clinical presentation, management and prognosis when necessary and finally, neuroimaging with emphasis on magnetic resonance imaging. The primary purpose of this review is to provide an organized approach to the differential diagnosis and typical imaging patterns for AVSs. We have provided a template for radiologists and specialists to assist in early intervention in order to decrease morbidity and provide value-based patient care through imaging.

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Transverse Sinus Stenting for Pseudotumor Cerebri: A Cost Comparison with CSF Shunting

Cited by 49 publications

References 22 publications

Venous sinus stenting is a valuable treatment for fulminant idiopathic intracranial hypertension

Venous sinus stenting is a valuable treatment for fulminant idiopathic intracranial hypertension

Meta-Analysis of CSF Diversion Procedures and Dural Venous Sinus Stenting in the Setting of Medically Refractory Idiopathic Intracranial Hypertension

MRI in the Evaluation of Acute Visual Syndromes

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