Long-term Kinetic Papilledema Improvement After Venous Sinus Stenting in Idiopathic Intracranial Hypertension

Background and Purpose The aim of this study was to assess the safety and effectiveness of lateral sinus stenosis (LSS) stenting in patients with idiopathic intracranial hypertension (IIH) who are refractory to medical treatment, particularly focusing on visual outcomes including papilledema. Materi...

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Bibliographic Details
Published in:Clinical neuroradiology (Munich) 2021-06, Vol.31 (2), p.483-490
Main Authors: Touzé, Romain, Bonnin, Sophie, Houdart, Emmanuel, Nicholson, Patrick, Bodaghi, Bahram, Shotar, Eimad, Clarençon, Frédéric, Lenck, Stéphanie, Touitou, Valérie
Format: Article
Language:English
Subjects:
Care and treatment
Complications and side effects
Human health and pathology
Hypertension
Intracranial hypertension
Life Sciences
Local anesthesia
Magnetic resonance imaging
Medical imaging
Medical research
Medical treatment
Medicine
Medicine & Public Health
Medicine, Experimental
Neurology
Neurons and Cognition
Neuroradiology
Neurosurgery
Optics
Original Article
Patients
Sensory Organs
Sinuses
Stent (Surgery)
Tinnitus
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Summary:Background and Purpose The aim of this study was to assess the safety and effectiveness of lateral sinus stenosis (LSS) stenting in patients with idiopathic intracranial hypertension (IIH) who are refractory to medical treatment, particularly focusing on visual outcomes including papilledema. Material and Methods Retrospective study of consecutive patients with IIH refractory to medical treatment who underwent LSS stenting. Clinical features, visual fields and optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thicknesses were assessed before stenting, at 1 month poststenting and at last follow-up. Complications were also recorded. Results A total of 16 women were included, with a mean age of 39 ± 11 years. All patients had papilledema while 15/16 (94%) had headaches. Mean visual acuity was 0.036 logMAR, range (+0.4 to +0.0 logMAR). The mean RNFL thickness prior to stenting was 121.7 µm (±34.7 µm) and mean GCL thickness was 80.2 µm (±8.9 µm). Mean follow-up was 19.7 months (±11.8 months). After stenting, acetazolamide was discontinued in 15/16 (94%) patients. Papilledema improved in 14/16 (88%) of patients. The mean RNFL thickness was significantly decreased 1 month after stenting (96.3 ± 15.6 µm; p  
ISSN:1869-1439
1869-1447
DOI:10.1007/s00062-020-00908-z