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Venous sinus stenting lowers the intracranial pressure in patients with idiopathic intracranial hypertension

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Aims: We report the cerebrospinal fluid opening pressure (CSF-OP) measurements obtained before and after venous sinus stenting (VSS) in 50 patients with idiopathic intracranial hypertension.

Methods: The CSF-OP was measured with a spinal tap 3 months before and 3 months after treatment. All data were prospectively collected and included patient demographics, weight (kg), body mass index (BMI), acetazolamide daily dosage (mg), procedural details, complications, venous sinus pressures (mm Hg), transstenotic pressure gradient (mm Hg), transverse sinus symmetry, and type of venous sinus stenosis.

Results: The average pretreatment CSF-OP was 37 cm H2 O (range 25–77) and the average posttreatment CSF-OP was 20.2 cm H2 O (range 10–36), with an average reduction of 16.8 cm H2 O (P<0.01). The post-treatment CSF-OP was less than 25 cm H2 O in 40/50 patients. The average acetazolamide daily dose decreased from 950mg to 300mg at the time of 3-month follow-up (P<0.01). No patient required an increase in acetazolamide dose 3 months after VSS. The average weight before treatment was 95.4 kg with an average BMI of 35.41. There was an average increase in body weight of 1.1 kg at the 3-month follow-up with an average increase in BMI of 0.35 (P=0.03).

Conclusions: We provide evidence that there is a significant decrease in CSF-OP in patients with idiopathic intracranial hypertension 3 months after VSS, independent of acetazolamide usage or weight loss.

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Publication Name: 
Journal of NeuroInterventional Surgery
Authors: 
Athos Patsalides, Cristiano Oliveira, Jessica Wilcox, Kenroy Brown, Kartikey Grover, Yves Pierre Gobin, Marc J Dinkin

 

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