Stent Pseudotumor

J Neurosurg 116:538–548, 2012

Dural sinus stent placement for idiopathic
intracranial hypertension
Clinical article
DAVID A. KUMPE, M.D.,1,2 JEFFREY L. BENNETT, M.D., PH.D., 3,4 JOSHUA SEINFELD, M.D.,1,2
VICTORIA S. PELAK, M.D., 3,4 ASHISH CHAWLA, M.D.,1 AND MARY TIERNEY, N. P.1
Departments of 1Radiology, 2Neurosurgery, 3Neurology, and 4Ophthalmology, University of Colorado
AnschutzMedical Campus, Aurora, Colorado
Object.
hemodynamic outcome of placement of unilateral dural sinus stents to treat intracranial venous hypertension in a
Methods.

-

2

-

Results.
-

Conclusions.

(DOI: 10.3171/2011.10.JNS101410)

KEY WORDS

I

intracranial hypertension, or pseudotumor
cerebri, is an uncommon condition that most common-

DIOPATHIC

-

IIH include dailyheadache, pulse-synchronous tinnitus,

-

papilledema can develop, which can be associated with
39
Idiopathic intracranial hypertension is a chronic condition that may worsen after a pe35

-

12,16,18

Abbreviations used in this paper:
22

some patients with IIH, increased ICP is caused by ve538

J Neurosurg / Volume 116 / March 2012

Dural sinus stents for idiopathicintracranial hypertension
Currently, there

-

intracranial sinus pressures were invariably reduced by
ical follow-up has been favorable, there are very limited
follow-up data on the hemodynamic performance of the

-

5,13,32

Body Mass Index

-

2

2
2

Neuroimaging Studies

-

studies were interpreted as normal with no mention of the

Patient Demographics
Dural SinusAnatomy

patients had headaches: 10 chronic, 1 intermittent, and
had papilledema at some time in their clinical course, and

-

these patients had papilledema with acute retinal hem-

system drained into the nondominant side, and the super-

-

Operative Procedures

tient had 2 separate stent placements after a hemodynam-

25 cm H2
2

O,

cm H 2

raphy, venous manometry, andselective intracranial dural
-

Prior Surgical Procedures

Prior to stent placement, 3 patients had ventriculo-

on the side that appeared to be most appropriate anatomi-

noted initial improvement but then deterioration in visual
tients (Cases 9 and 12) suffered catastrophic vision loss in
the operated eye within 1 and 2 months of the operation,
J Neurosurg / Volume 116 / March 2012catheter was then advanced into the posterior superior
-

539

TABLE 1: Patient demographics*
Lumbar Puncture
Opening Pressure
Vision
Duration of
(cm H2O)
Disturbance Symptoms (mos) BMI (kg/m2)

Case No.

Age at Stent
Placement
(yrs), Sex

Headache

1

41, F

yes

yes

2
3
4
5
6a
6b (stent 2)
7
8
9
10
11
12
13
14
15

16, F
58, M
30, M
52, M
25, F59, F
28, F
27, F
62, M
22, F
58, F
36, F
23, F
44, M

yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
lt r t

16
17
18

23, F
53, M
26, F

yes
no
no
no
yes
yes
yes
yes
yes
no
yes
yes
yes
yes
no at present; h/a in
2005 before
weight loss
yes
no
yes

yes
no
yes

240

0.75
27
12
4
72
78
72
4.5
27
30
10
35
2.5
3660
120
12

38

36

Shunt Placed

ONSF
lt

none
none
none
rt
none
none
none
yes
bilat
none
rt
rt
none
none
lt

none
none
none

37.9
26.2
28.6
33.9
24.4
36.4
35.8
31.1
31.3
33.4

34
33
43.5
34
55
44
25
50
elevated

multiple shunts w/ infection pre- and poststent
none
none
none
none
yes 2001
yes
none
multiple
none
none
none
none
nonenone
none

34.4
37.8
30.9

55
26
not available

none
none
none

22.6
28.2
31.9
26

50
elevated
36
33
elevated

* All patients had papilledema. Abbreviation: h/a = headache.

Stent Procedures

-

-

-

Pressure measurements were repeated from the torcular
Pressure Gradients

-

540

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J Neurosurg / Volume 116 / March 2012

Dural sinus stents for...