Transverse venous sinus stenting for fulminant idiopathic intracranial hypertension during pregnancy: a report of two cases and literature review.

BACKGROUND

Fulminant idiopathic intracranial hypertension (FIIH) is a rapidly progressive condition that carries a high risk of permanent vision loss, and is thus considered a medical emergency requiring immediate intervention. Cerebral venous sinus stenting (VSS) has gained recognition in recent years as an effective treatment for idiopathic intracranial hypertension (IIH) in patients resistant or intolerant to medical therapy. The advantage of VSS over other surgical options is its less invasive nature (endovascular procedure) and its potential to yield improvement of additional disease symptoms, such as headaches and pulsatile tinnitus. While growing evidence supports the safety and efficacy of VSS in elective cases, data on its outcomes when performed emergently in FIIH is limited and even scarcer regarding its use during pregnancy.

CASE DESCRIPTION

This is a retrospective description of two pregnant women in their second trimester presenting with signs and symptoms of FIIH that were both refractory to medical treatment and had demonstrated progressive visual field loss. Both patients underwent emergent cerebral VSS, with no intra- or post-procedural complications. Both patients experienced a marked resolution of their symptoms following the operation and successfully delivered healthy newborns via elective cesarean section at 37 weeks of pregnancy.

CONCLUSIONS

This report contributes additional data to the small growing body of evidence regarding FIIH treatment in pregnancy. Based on these two cases, emergent VSS treatment for FIIH in pregnant women can be considered a valid treatment option.