Miyoshi Masaki, Tabuchi Akio, Mimura Osamu, Nagahama Atsufumi, Tabuchi Hitoshi
Ophthalmology, Tsukazaki Hospital, Himeji, JPN.
Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, JPN.
Cureus. 2023 Aug 20;15(8):e43828. doi: 10.7759/cureus.43828. eCollection 2023 Aug.
Superior sagittal sinus (SSS) obstruction causes intracranial hypertension, often requiring surgical stenting. Consensus on treating brain venous sinus stenosis, another cause, is lacking. This study reports a case of SSS stenosis and intracranial hypertension treated with venous stenting, improving bilateral papilledema. A 51-year-old with a headache and visual disturbance had papilledema and visual field loss. MR venography showed SSS stenosis, leading to a neurosurgery referral. Lumbar puncture confirmed intracranial hypertension (>35 cmH2O), prompting venous stenting. Post-procedure, papilledema, headache, and visual field loss improved. Venous stenting could be effective for SSS stenosis with clinically proven or recurrent pressure differences. Further cases are needed for standardization.
上矢状窦(SSS)梗阻会导致颅内高压,通常需要进行手术支架置入。对于另一种病因——脑静脉窦狭窄的治疗,目前尚未达成共识。本研究报告了一例通过静脉支架置入治疗SSS狭窄和颅内高压的病例,患者双侧视乳头水肿得到改善。一名51岁出现头痛和视力障碍的患者有视乳头水肿和视野缺损。磁共振静脉血管造影显示SSS狭窄,遂转诊至神经外科。腰椎穿刺证实颅内高压(>35 cmH₂O),促使进行静脉支架置入。术后,视乳头水肿、头痛和视野缺损均有所改善。静脉支架置入对于经临床证实或反复出现压力差的SSS狭窄可能有效。需要更多病例来实现标准化。