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  • Point:Dural venous sinus stenting should be considered a first-line treatment option for select patients with idiopathic intracranial hypertension

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Point:Dural venous sinus stenting should be considered a first-line treatment option for select patients with idiopathic intracranial hypertension
  1. Michael R Levitt1,2,3,4
  1. 1 Neurological Surgery, University of Washington School of Medicine, Seattle, Washington, USA
  2. 2 Radiology, University of Washington, Seattle, WA, USA
  3. 3 Mechanical Engineering, University of Washington, Seattle, WA, USA
  4. 4 Stroke & Applied Neuroscience Center, University of Washington, Seattle, WA, USA
  1. Correspondence to Dr Michael R Levitt, Neurological Surgery, University of Washington School of Medicine, Seattle, Washington, USA; mlevitt{at}uw.edu

https://doi.org/10.1136/jnis-2023-020597

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    There is substantial recent interest in the pages of JNIS regarding cerebral venous disease. Considered a neglected area in neurointervention for many years, there has been an uptick particularly in the study of venous sinus stenosis and idiopathic intracranial hypertension (IIH; previously known as pseudotumor cerebri). A recent editorial1 described the first meeting of the SNIS Cerebral Venous and Cerebrospinal Fluid (CSF) Disorders Committee, including a motivation to ‘provide thought leadership for the SNIS on the science, regulatory, device innovation, and clinical trials related to these disease processes’. The formation of this committee is welcome, and needed, to provide assistance to neurointerventionalists treating cerebral venous disorders.

    Stenting for IIH is perhaps the most common cerebral venous treatment currently performed by neurointerventionalists.2 This procedure originally grew from observations of venous sinus stenosis in patients with IIH, followed by early reports of balloon angioplasty providing temporary symptomatic relief.3 The advent of improved catheter and stent technology provided the opportunity for stenting to become a viable alternative to typical cerebrospinal fluid (CSF) diversion surgery for IIH treatment. In conjunction, a reappraisal of the pathophysiological relationship between CSF absorption and venous drainage4 has transformed IIH from an ‘orphan disease’ to a cerebrovascular disorder …

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    Footnotes

    • Twitter @DrMichaelLevitt

    • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests Unrestricted educational grants from Medtronic and Stryker; consulting agreement with Medtronic, Aeaean Advisers and Metis Innovative; equity interest in Proprio, Cerebrotech, Apertur, Stereotaxis, Fluid Biomed, and Hyperion Surgical; editorial board of Journal of NeuroInterventional Surgery and Frontiers in Surgery.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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