一例经横窦支架置入术治疗的特发性颅内高压病例。
A Case of Idiopathic Intracranial Hypertension Treated by Transverse Sinus Stenting.
作者信息
Miki Kazunori, Sumita Kazutaka, Fujii Shoko, Fujita Kyohei, Aizawa Yuki, Karakama Jun, Yoshino Yoshikazu, Emoto Hirofumi, Nemoto Shigeru
机构信息
Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan.
出版信息
J Neuroendovasc Ther. 2021;15(10):653-658. doi: 10.5797/jnet.cr.2020-0145. Epub 2021 Jan 28.
OBJECTIVE
We report a patient with chronic headache due to idiopathic intracranial hypertension (IIH) associated with transverse sinus (TS) stenosis. The symptom improved after stent placement at the site of stenosis.
CASE PRESENTATION
The patient was a 37-year-old woman with progressive headache and diplopia as chief complaints. She had severe bilateral papilledema. Magnetic resonance imaging (MRI) and angiography revealed stenosis of the bilateral TS. Lumbar puncture demonstrated raised intracranial pressure and IIH was tentatively diagnosed. Visual impairment progressed despite oral acetazolamide therapy. A venous pressure gradient was monitored during stent placement. The pressure gradient improved after stenting. Dual antiplatelet therapy was initiated 1 week before the procedure. Papilledema and headache resolved immediately after the procedure. No in-stent stenosis or occlusion occurred during the follow-up period.
CONCLUSION
Stent placement for TS stenosis can improve the cerebral venous return in IIH patients. Although restenosis is possible, venous sinus stenting is considered an effective treatment.
目的
我们报告一例因特发性颅内高压（IIH）伴横窦（TS）狭窄导致慢性头痛的患者。狭窄部位置入支架后症状改善。
病例介绍
该患者为一名37岁女性，以进行性头痛和复视为主要症状。她有严重的双侧视乳头水肿。磁共振成像（MRI）和血管造影显示双侧TS狭窄。腰椎穿刺显示颅内压升高，初步诊断为IIH。尽管口服乙酰唑胺治疗，视力损害仍进展。在置入支架过程中监测静脉压力梯度。支架置入后压力梯度改善。术前1周开始双联抗血小板治疗。术后视乳头水肿和头痛立即缓解。随访期间未发生支架内狭窄或闭塞。
结论
TS狭窄置入支架可改善IIH患者的脑静脉回流。尽管可能发生再狭窄，但静脉窦支架置入术被认为是一种有效的治疗方法。
Zotero 插件