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Abstract
Background Venous sinus stenosis is believed to play a role in the pathogenesis of idiopathic intracranial hypertension (IIH). Venous stenting has emerged as a promising treatment option for patients with IIH. In this technical note, we present a case of IIH with the highest recorded pressure gradient till today.
Clinical Presentation This technical note presents the successful use of intracranial venous stenting in a patient with IIH due to severe venous sinus stenosis, leading to significant improvement in vision and reduction in intracranial pressure. Ameticulous review of the literature revealed that our patient exhibited the highest recorded pressure gradient (70 cm of H2O). This remarkable finding underscores the potential effectiveness of venous stenting as a viable treatment approach. The procedure involved the placement of a Zilver stent and balloon angioplasty post stenting of the right transverse sinus stenosis, resulting in a substantial decrease in pressure gradient. Following the procedure, another venous manometry showed no more gradient with a uniform pressure in the whole venous system at 18 cm of H2O.
Conclusion To our knowledge, this case presents the highest-pressure gradient reported in the literature and contributes to the growing evidence supporting venous stenting in patients with IIH and venous sinus stenosis.
Disclosures K. El Naamani: None. M. Ghanem: None. S. Tjoumakaris: 2; C; MicroVention. M. Gooch: 2; C; Stryker. R. Rosenwasser: None. P. Jabbour: 2; C; MicroVention, Medtronic, Balt, Ceres Endovascular.