Entezami Pouya, Gooch M Reid, Dalfino John
Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
Neurological Surgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.
BMJ Case Rep. 2019 Apr 5;12(4):e227935. doi: 10.1136/bcr-2018-227935.
Idiopathic intracranial hypertension (IIH) is a challenging disease with unclear pathophysiology. Recognition of venous sinus stenting to improve intracranial pressure is increasing.We present a 56-year-old man diagnosed with IIH. A parasagittal meningioma abutting the sagittal sinus causing venous compression was found. Venous sinus stenting via endovascular approach using a WALLSTENT was performed. Intravascular pressures recorded after stenting demonstrated resolution of the pressure gradient.The patient had no complications from the procedure and reported substantial symptomatic improvement. Subsequent ophthalmologic exam demonstrated resolution of the bilateral papilledema noted prior to stenting. Endovascular treatment of venous sinus stenosis in the treatment of IIH is an emerging technique. Treatment of venous compromise due to a mass lesion with stenting is a rarely described concept. For our patient, endovascular stenting was the primary treatment modality, allowing the tumour to be followed with serial imaging.
特发性颅内高压(IIH)是一种病理生理学尚不明确的具有挑战性的疾病。认识到静脉窦支架置入术可改善颅内压的情况正在增加。我们报告一名56岁被诊断为IIH的男性。发现一个矢状窦旁脑膜瘤紧邻矢状窦,导致静脉受压。采用WALLSTENT通过血管内途径进行了静脉窦支架置入术。支架置入后记录的血管内压力显示压力梯度消失。患者手术无并发症,且报告症状有显著改善。随后的眼科检查显示支架置入术前发现的双侧视乳头水肿消退。血管内治疗静脉窦狭窄以治疗IIH是一种新兴技术。用支架治疗因占位性病变导致的静脉受压是一个鲜有描述的概念。对于我们的患者,血管内支架置入术是主要治疗方式,从而能够通过系列影像学检查对肿瘤进行随访。