Tags

Type your tag names separated by a space and hit enter

Pseudotumor cerebri syndrome: venous sinus obstruction and its treatment with stent placement.
J Neurosurg. 2003 May; 98(5):1045-55.JN

Abstract

OBJECT

Pseudotumor cerebri, or benign intracranial hypertension, is a condition of raised intracranial pressure in the absence of a mass lesion or cerebral edema. It is characterized by headache and visual deterioration that may culminate in blindness. Pseudotumor cerebri is caused by venous sinus obstruction in an unknown percentage of cases. The purpose of this study was to investigate the role of cerebral venous sinus disease in pseudotumor cerebri and the potential of endoluminal venous sinus stent placement as a new treatment.

METHODS

Nine consecutive patients in whom diagnoses of pseudotumor cerebri had been made underwent examination with direct retrograde cerebral venography (DRCV) and manometry to characterize the morphological features and venous pressures in their cerebral venous sinuses. The cerebrospinal fluid (CSF) pressure was measured simultaneously in two patients. If patients had an amenable lesion they were treated using an endoluminal venous sinus stent. Five patients demonstrated morphological obstruction of the venous transverse sinuses (TSs). All lesions were associated with a distinct pressure gradient and raised proximal venous sinus pressures. Four patients underwent stent insertion in the venous sinuses and reported that their headaches improved immediately after the procedure and remained so at 6 months. Vision was improved in three patients, whereas it remained poor in one despite normalized CSF pressures.

CONCLUSIONS

Patients with pseudotumor cerebri should be evaluated with DRCV and manometry because venous TS obstruction is probably more common than is currently appreciated. In patients with a lesion of the venous sinuses, treatment with an endoluminal venous sinus stent is a viable alternative for amenable lesions.

Authors+Show Affiliations

Department of Neurosurgery, Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, New South Wales, Sydney, Australia. brianowl@bigpond.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

12744365

Citation

Owler, Brian K., et al. "Pseudotumor Cerebri Syndrome: Venous Sinus Obstruction and Its Treatment With Stent Placement." Journal of Neurosurgery, vol. 98, no. 5, 2003, pp. 1045-55.
Owler BK, Parker G, Halmagyi GM, et al. Pseudotumor cerebri syndrome: venous sinus obstruction and its treatment with stent placement. J Neurosurg. 2003;98(5):1045-55.
Owler, B. K., Parker, G., Halmagyi, G. M., Dunne, V. G., Grinnell, V., McDowell, D., & Besser, M. (2003). Pseudotumor cerebri syndrome: venous sinus obstruction and its treatment with stent placement. Journal of Neurosurgery, 98(5), 1045-55.
Owler BK, et al. Pseudotumor Cerebri Syndrome: Venous Sinus Obstruction and Its Treatment With Stent Placement. J Neurosurg. 2003;98(5):1045-55. PubMed PMID: 12744365.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pseudotumor cerebri syndrome: venous sinus obstruction and its treatment with stent placement. AU - Owler,Brian K, AU - Parker,Geoffrey, AU - Halmagyi,G Michael, AU - Dunne,Victoria G, AU - Grinnell,Verity, AU - McDowell,David, AU - Besser,Michael, PY - 2003/5/15/pubmed PY - 2003/6/5/medline PY - 2003/5/15/entrez SP - 1045 EP - 55 JF - Journal of neurosurgery JO - J Neurosurg VL - 98 IS - 5 N2 - OBJECT: Pseudotumor cerebri, or benign intracranial hypertension, is a condition of raised intracranial pressure in the absence of a mass lesion or cerebral edema. It is characterized by headache and visual deterioration that may culminate in blindness. Pseudotumor cerebri is caused by venous sinus obstruction in an unknown percentage of cases. The purpose of this study was to investigate the role of cerebral venous sinus disease in pseudotumor cerebri and the potential of endoluminal venous sinus stent placement as a new treatment. METHODS: Nine consecutive patients in whom diagnoses of pseudotumor cerebri had been made underwent examination with direct retrograde cerebral venography (DRCV) and manometry to characterize the morphological features and venous pressures in their cerebral venous sinuses. The cerebrospinal fluid (CSF) pressure was measured simultaneously in two patients. If patients had an amenable lesion they were treated using an endoluminal venous sinus stent. Five patients demonstrated morphological obstruction of the venous transverse sinuses (TSs). All lesions were associated with a distinct pressure gradient and raised proximal venous sinus pressures. Four patients underwent stent insertion in the venous sinuses and reported that their headaches improved immediately after the procedure and remained so at 6 months. Vision was improved in three patients, whereas it remained poor in one despite normalized CSF pressures. CONCLUSIONS: Patients with pseudotumor cerebri should be evaluated with DRCV and manometry because venous TS obstruction is probably more common than is currently appreciated. In patients with a lesion of the venous sinuses, treatment with an endoluminal venous sinus stent is a viable alternative for amenable lesions. SN - 0022-3085 UR - https://www.unboundmedicine.com/medline/citation/12744365/Pseudotumor_cerebri_syndrome:_venous_sinus_obstruction_and_its_treatment_with_stent_placement_ L2 - https://thejns.org/doi/10.3171/jns.2003.98.5.1045 DB - PRIME DP - Unbound Medicine ER -