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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleNeurointerventionE

Transverse Sinus Stenting for Idiopathic Intracranial Hypertension: A Review of 52 Patients and of Model Predictions

R.M. Ahmed, M. Wilkinson, G.D. Parker, M.J. Thurtell, J. Macdonald, P.J. McCluskey, R. Allan, V. Dunne, M. Hanlon, B.K. Owler and G.M. Halmagyi
American Journal of Neuroradiology September 2011, 32 (8) 1408-1414; DOI: https://doi.org/10.3174/ajnr.A2575
R.M. Ahmed
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M. Wilkinson
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G.D. Parker
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M.J. Thurtell
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J. Macdonald
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P.J. McCluskey
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R. Allan
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V. Dunne
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M. Hanlon
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B.K. Owler
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G.M. Halmagyi
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    Fig 1.

    A, Example of a stenosis due to extrinsic compression (long narrowed segment, arrow). B, Example of an intrinsic stenosis caused by a large arachnoid granulation (arrow). C, Example of an intrinsic stenosis caused by a septal band (arrow).

Tables

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    Table 1:

    Clinical parameters in patients with IIH before and after transverse sinus stent placement

    Clinical ParameterBefore StentAfter Stent
    MildModerateSevereMildModerateSevere
    Papilledema11a2770b00
    Visual acuity loss445310
    Visual field loss19c65520
    Headache6221508d0
    Transient visual obscurations3106000
    Pulsatile tinnitus692000
    Diplopia321000
    • a One patient with optic atrophy.

    • b Four patients with optic atrophy.

    • c Twelve patients with only enlarged blind spots.

    • d Six patients who were re-stented.

    • View popup
    Table 2:

    Type of transverse sinus stenosis found at direct venography in 52 patients with IIH

    Type of StenosisNo.
    Intrinsic/extrinsic of both sinuses16
    Intrinsic/extrinsic of dominant sinus, hypoplastic sinus8
    Intrinsic of both sinuses8
    Intrinsic of dominant, hypoplastic sinus9
    Extrinsic of both sinuses7
    Extrinsic of dominant, hypoplastic sinus4
    • View popup
    Table 3:

    Venous pressures before and after transverse sinus stent placement in 46 patients with IIH with and 6 without papilledemaa

    Superior Sagittal Sinus Pressure Pre-stent (mm Hg)Superior Sagittal Sinus Pressure Post-stent (mm Hg)Gradient Pre-stent(mm Hg)Gradient Post-stent(mm Hg)
    With papilledema3416200.7
    (n = 46)(15–94)(11–33)(6–41)(0–14)
    (n = 46)(n = 44)(n = 46)(n = 46)
    Without papilledema2511120
    (n = 6)(18–34)(7–14)(4–15)
    (n = 6)(n = 6)(n = 6)(n = 4)
    • a Ranges indicated in parentheses.

    • View popup
    Table 4:

    Venous pressures in 40 patients with IIH with papilledema requiring only 1 stent placement procedure versus 6 (all with papilledema at first stent) requiring a second stent placement procedurea

    Superior Sagittal Sinus Pre-stent (mm Hg)Superior Sagittal Sinus Post-stent (mm Hg)Gradient Pre-stent (mm Hg)Gradient Post-stent (mm Hg)
    Single stent3117190.4
    (n = 40, all with papilledema)(15–94)(11–33)(6–36)(0–5)
    (n = 40)(n = 39)(n = 40)(n = 40)
    Repeat stents, on 1st stent4318292.8
    (n = 6, all with papilledema prior to first stent)(18–56)(11–32)(15–41)(0–14)
    (n = 6)(n = 5)(n = 6)(n = 6)
    • a Ranges indicated in parentheses.

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American Journal of Neuroradiology: 32 (8)
American Journal of Neuroradiology
Vol. 32, Issue 8
1 Sep 2011
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R.M. Ahmed, M. Wilkinson, G.D. Parker, M.J. Thurtell, J. Macdonald, P.J. McCluskey, R. Allan, V. Dunne, M. Hanlon, B.K. Owler, G.M. Halmagyi
Transverse Sinus Stenting for Idiopathic Intracranial Hypertension: A Review of 52 Patients and of Model Predictions
American Journal of Neuroradiology Sep 2011, 32 (8) 1408-1414; DOI: 10.3174/ajnr.A2575

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Transverse Sinus Stenting for Idiopathic Intracranial Hypertension: A Review of 52 Patients and of Model Predictions
R.M. Ahmed, M. Wilkinson, G.D. Parker, M.J. Thurtell, J. Macdonald, P.J. McCluskey, R. Allan, V. Dunne, M. Hanlon, B.K. Owler, G.M. Halmagyi
American Journal of Neuroradiology Sep 2011, 32 (8) 1408-1414; DOI: 10.3174/ajnr.A2575
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  • Dynamic internal jugular vein venography: a descriptive study in 89 patients with suspected cerebral venous outflow disorders
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  • Dural sinus septum: an underlying cause of cerebral venous sinus stenting failure and complications
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  • Visual and pharmacotherapy outcomes after transverse sinus stenting for idiopathic intracranial hypertension
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  • Major complications of dural venous sinus stenting for idiopathic intracranial hypertension: case series and management considerations
  • Predicting the need for retreatment in venous sinus stenting for idiopathic intracranial hypertension
  • Reductions in bilateral transverse sinus pressure gradients with unilateral transverse venous sinus stenting for idiopathic intracranial hypertension
  • Mid-term assessment of transverse sinus stent patency in 104 patients treated for intracranial hypertension secondary to dural sinus stenosis
  • Changes in mean arterial pressure and end-tidal carbon dioxide content affect venous sinus pressures in patients with idiopathic intracranial hypertension: a randomized study
  • A descriptive study of venous sinus pressures and gradients in patients with idiopathic intracranial hypertension
  • Intracranial venous sinus stenosis: hemodynamic assessment with two-dimensional parametric parenchymal blood flow software on digital subtraction angiography
  • Empty Sella Is a Sign of Symptomatic Lateral Sinus Stenosis and Not Intracranial Hypertension
  • The Occipital Emissary Vein: A Possible Marker for Pseudotumor Cerebri
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  • Differences in the Calculated Transvenous Pressure Drop between Chronic Hydrocephalus and Idiopathic Intracranial Hypertension
  • Correlation between angiographic stenosis and physiologic venous sinus outflow obstruction in idiopathic intracranial hypertension
  • Recommendations for the selection and treatment of patients with idiopathic intracranial hypertension for venous sinus stenting
  • Hemodynamic assessments of venous pulsatile tinnitus using 4D-flow MRI
  • Retrograde 3D rotational venography (3DRV) for venous sinus stent placement in idiopathic intracranial hypertension
  • Augmented 3D venous navigation for neuroendovascular procedures
  • Indications for the Performance of Intracranial Endovascular Neurointerventional Procedures: A Scientific Statement From the American Heart Association
  • Quantitative Phase-Contrast MR Angiography to Measure Hemodynamic Changes in Idiopathic Intracranial Hypertension
  • Pattern of pressure gradient alterations after venous sinus stenting for idiopathic intracranial hypertension predicts stent-adjacent stenosis: a proposed classification system
  • A pilot study and novel angiographic classification for superior sagittal sinus stenting in patients with non-thrombotic intracranial venous occlusive disease
  • Predictors for venous sinus stent retreatment in patients with idiopathic intracranial hypertension
  • Comparison of venous sinus manometry gradients obtained while awake and under general anesthesia before venous sinus stenting
  • Intracranial venous pressures under conscious sedation and general anesthesia
  • Sigmoid Sinus Diverticulum, Dehiscence, and Venous Sinus Stenosis: Potential Causes of Pulsatile Tinnitus in Patients with Idiopathic Intracranial Hypertension?
  • Dural sinus stenting for idiopathic intracranial hypertension: factors associated with hemodynamic failure and management with extended stenting
  • Patency of the vein of Labbe after venous stenting of the transverse and sigmoid sinuses
  • Venous sinus stenting in patients without idiopathic intracranial hypertension
  • A new index for the assessment of transverse sinus stenosis for diagnosing idiopathic intracranial hypertension
  • Republished: Delayed relapse in pseudotumor cerebri due to new stenosis after transverse sinus stenting
  • Computational Modeling of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension
  • Venous sinus stenting for idiopathic intracranial hypertension is not associated with cortical venous occlusion
  • Republished: Reversible transverse sinus collapse in a patient with idiopathic intracranial hypertension
  • Stents for Idiopathic Intracranial Hypertension: Meta-Analyzed, Hypo-Analyzed, and In Need of a Trial
  • Progressive versus Nonprogressive Intracranial Dural Arteriovenous Fistulas: Characteristics and Outcomes
  • Meta-Analysis of CSF Diversion Procedures and Dural Venous Sinus Stenting in the Setting of Medically Refractory Idiopathic Intracranial Hypertension
  • Delayed relapse in pseudotumor cerebri due to new stenosis after transverse sinus stenting
  • Reversible transverse sinus collapse in a patient with idiopathic intracranial hypertension
  • A practical approach to, diagnosis, assessment and management of idiopathic intracranial hypertension
  • Transverse Sinus Stenting for Pseudotumor Cerebri: A Cost Comparison with CSF Shunting
  • Long-term patency of venous sinus stents for idiopathic intracranial hypertension
  • Venous sinus stenting for idiopathic intracranial hypertension: a review of the literature
  • Concomitant intracranial pressure monitoring during venous sinus stenting for intracranial hypertension secondary to venous sinus stenosis
  • Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis
  • Dural venous sinus angioplasty and stenting for the treatment of idiopathic intracranial hypertension
  • Update on the pathophysiology and management of idiopathic intracranial hypertension
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