White Timothy G, Chen Adrian, Dalal Sidd, Mehta Shyle H, Turpin Justin, Papadimitriou Kyriakos, Link Thomas, Patsalides Athos
Department of Neurological Surgery, North Shore University Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA.
Department of Neurology, North Shore University Hospital/Long Island Jewish Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA.
Interv Neuroradiol. 2024 Aug 2:15910199241267341. doi: 10.1177/15910199241267341.
Tumors that invade or compress the venous sinuses have the potential to impair venous drainage. Rarely, this may be so severe as to induce intracranial hypertension. Other studies have previously described venous sinus stenting (VSS) for the treatment of these symptomatic lesions. In this report, we present our series of eight cases of VSS for symptomatic tumor-induced venous sinus stenosis and review the existing literature.
Eight patients with mostly intracranial tumors were found to have symptomatic venous sinus stenosis with the most common presenting symptom being elevated intracranial pressure. Six of the eight (75%) patients presented with papilledema on neuro-ophthalmological exam. The most affected locations were the transverse and sigmoid sinuses in four patients, followed by the superior sagittal sinus in three patients. All eight patients underwent VSS with no adverse events. In total, 6 out of 8 (75%) of patients had complete resolution of their symptoms, while the remaining patients experienced at least partial improvement.
Tumors that cause symptomatic venous sinus stenosis may be successfully managed with VSS to improve venous drainage. This may facilitate continued conservative management of meningiomas or allow for treatment with noninvasive means, such as stereotactic radiosurgery. Depending on the size of the target stenosis, balloon-mounted coronary stents may be a suitable option to treat these lesions.
侵犯或压迫静脉窦的肿瘤有可能损害静脉引流。很少情况下，这种损害可能非常严重，以至于引发颅内高压。此前其他研究已描述了静脉窦支架置入术（VSS）用于治疗这些有症状的病变。在本报告中，我们展示了我们治疗有症状的肿瘤引起的静脉窦狭窄的8例VSS病例系列，并回顾了现有文献。
8例主要患有颅内肿瘤的患者被发现有症状性静脉窦狭窄，最常见的症状是颅内压升高。8例患者中有6例（75%）在神经眼科检查时出现视乳头水肿。受影响最严重的部位是4例患者的横窦和乙状窦，其次是3例患者的上矢状窦。所有8例患者均接受了VSS，无不良事件发生。8例患者中有6例（75%）症状完全缓解，其余患者至少有部分改善。
导致有症状性静脉窦狭窄的肿瘤可以通过VSS成功治疗，以改善静脉引流。这可能有助于对脑膜瘤继续进行保守治疗，或允许采用非侵入性手段进行治疗，如立体定向放射外科治疗。根据目标狭窄的大小，球囊冠状动脉支架可能是治疗这些病变的合适选择。
