Higgins J Nicholas, Garnett Mathew R, Pickard John D, Axon Patrick R
Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom.
Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, United Kingdom.
J Neurol Surg B Skull Base. 2017 Apr;78(2):158-163. doi: 10.1055/s-0036-1594238. Epub 2016 Nov 23.
The extent to which intracranial venous sinus obstruction contributes to idiopathic intracranial hypertension (IIH) is debated. The extent to which extracranial venous obstruction contributes to IIH is virtually unexplored. This article describes an interventional approach to extracranial venous outflow in a group of patients with severe intractable symptoms. To describe our technique and experience of styloidectomy combined with jugular stenting in the treatment of skull base narrowing of the jugular veins. Retrospective review of all styloidectomies undertaken at our institution ( = 34), as an adjunct or alternative to jugular venous stenting, with a view to improving cranial venous outflow. Eleven styloidectomies were for delayed complications of jugular stenting. Of seven with stent dysfunction, three were improved and four unchanged. Of seven with accessory nerve compression (three had both), four resolved and three improved. In 23 instances, styloidectomy preceded or obviated jugular stenting. Two had a virtual resolution of symptoms, 13 were improved, and 8 were unchanged. Styloidectomy can replace, salvage, or complement jugular venous stenting in IIH and disturbances of cranial venous outflow.
颅内静脉窦阻塞对特发性颅内高压（IIH）的影响程度存在争议。颅外静脉阻塞对IIH的影响程度实际上尚未得到探索。本文描述了一种针对一组有严重顽固性症状患者的颅外静脉流出道的介入方法。描述我们在治疗颈静脉颅底狭窄时茎突切除术联合颈静脉支架置入术的技术和经验。回顾性分析我们机构进行的所有茎突切除术（n = 34），作为颈静脉支架置入术的辅助或替代方法，以改善颅静脉流出。11例茎突切除术用于颈静脉支架置入术的延迟并发症。在7例支架功能障碍患者中，3例改善，4例无变化。在7例副神经受压患者中（3例两者兼有），4例症状消失，3例改善。在23例中，茎突切除术先于或避免了颈静脉支架置入术。2例症状几乎完全缓解，13例改善，8例无变化。茎突切除术在IIH和颅静脉流出道紊乱中可替代、挽救或补充颈静脉支架置入术。
