Coronary Stent for Right Transverse Venous Sinus Stenosis in a Patient With Symptomatic Idiopathic Intracranial Hypertension

A 59-year-old woman was referred to the neuro-interventional team with complaints of headache, papilledema, and visual disturbances. Imaging and Lumbar puncture revealed signs consistent with idiopathic intracranial hypertension with stenosis of the right transverse venous sinus. The neurosurgery bo...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-03, Vol.15 (3), p.e36073
Main Authors: Perdomo Luna, Camilo A, Campaña Perilla, Laura, Cardona, José D, Jimenez-Hakim, Enrique, Mejía, Juan Andres
Format: Article
Language:English
Subjects:
Catheters
Headaches
Hypertension
Magnetic resonance imaging
Medical imaging
Neuroimaging
Neurology
Neurosurgery
Optic nerve
Patients
Radiology
Sinuses
Stents
Tinnitus
Veins & arteries
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Summary:A 59-year-old woman was referred to the neuro-interventional team with complaints of headache, papilledema, and visual disturbances. Imaging and Lumbar puncture revealed signs consistent with idiopathic intracranial hypertension with stenosis of the right transverse venous sinus. The neurosurgery board chose to treat her with an endovascular approach and stenting. During the procedure, the right jugular vein revealed decreased blood flow. This led to a left jugular vein access through the confluence of venous dural sinuses. However, an incomplete confluence required the catheter to ascend the superior sagittal sinus before descending to the right transverse sinus. The carotid catheter system kept herniating up the SSS, risking rupture. Given the intraoperative findings and the available equipment, a more flexible coronary catheter system was chosen. This catheter device allowed plasty and successful stent deployment. A lumbar puncture was performed, and the patient was discharged. A follow-up MRI at five weeks showed signs of intracranial hypertension improvement and the patient reported Improvement in symptoms. To our knowledge, this is the first time this type of device has been used in this anatomical location for this pathology.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.36073