Endovascular Treatment for Idiopathic Intracranial Hypertension Improves Clinical Symptoms and Signs

Abstract

Introduction New physiopathological concepts regarding idiopathic intracranial hypertension (IIH) recommend the endovascular treatment in refractory patients with transverse sinus stenosis.

Objectives To assess the role of the transverse sinus stenting treatment in the symptomatology of patients with IIH.

Method Clinically refractory patients with impaired venous drainage of the transverse sinus were submitted to cerebral angiographies. Patients with pre and post-stenotic pressure gradients > 8 mmHg were submitted to endovascular treatment.

Results Seven patients underwent cerebral angiography with manometry. Stenting was performed in six cases after pressure gradient assessment. All cases showed improvements in headache and resolution of papilledema.

Discussion and Conclusion Although the role of endovascular therapy should be further studied, our data suggest it may improve the clinical symptoms and signs of IIH in selected patients.

Resumo

Introdução Novos conceitos fisiopatológicos a respeito da hipertensão intracraniana idiopática (HII) propõem, em casos refratários, o tratamento endovascular em pacientes com estenose no seio transverso.

Objetivos Avaliar o efeito do tratamento endovascular, realizado pela implantação de um stent no seio transverso, em pacientes com HII.

Método Pacientes refratários clinicamente com alterações da drenagem venosa no seio transverso foram submetidos a angiografia cerebral. Diante de gradientes pressóricos pré e pós-estenóticos maiores do que 8 mmHg, foi feito o tratamento endovascular.

Resultados Sete pacientes realizaram angiografia cerebral com manometria. A colocação de stent foi realizada em seis após avaliação do gradiente pressórico. Todos apresentaram melhora da cefaleia, com resolução do papiledema.

Discussão e Conclusão Apesar de o papel do tratamento endovascular para HII necessitar de mais estudos, nossos dados sugerem que ele pode melhorar sinais e sintomas relacionados à HII em pacientes selecionados.

Keywords

cerebral angiography - endovascular procedures - pseudotumor cerebri

Palavras-chave

angiografia cerebral - procedimentos endovasculares - pseudotumor cerebral

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