Long-term Outcomes of refactory Idiopathic Intracranial Hypertension with cerebral venous sinus stenosis After Endovascular Stenting.

Background and purpose Cerebral venous sinus stenosis has been identified as a potential etiology in a number of idiopathic intracranial hypertension (IIH ) patients. Stenting may immediately relieve intracranial hypertension. However, the long-term outcomes of patients treated with this modality are not clear. Methods A over 12 years single-center analyzed of 62 patients undergoing stenting for medically refactory IIH with non-thrombotic and non-external compression cerebral venous sinus stenosis. Results The mean age of the 62 patients was 40 (range 13~62) years, females accounted for 67.7 % (42/62), and the mean body mass index was 26 (range 23~40). Headache was the most common presenting symptom (79%). Transient visual obscurations occurred in 69% of the patients. 42% of patients reported visual loss, while pulsatile tinnitus occurred in 11.3%. Papilledema was noted in 96.8% of patients preoperatively. The mean trans-stenotic pressure gradients were 6~43 mmHg prior to and 0~4 mmHg post-stenting, respectively. At 12~126 (the median was 62) months follow up post stenting; 91.9% (57/62) of the patients obtained good outcomes, headaches disappeared in 96% (47/49) and papilledema was attenuated in 98.3%(59/60) patients. There were 5 patients with poor outcomes. This included optic disc atrophy which was residual in two patient, and re-stenosis with intra-stent thrombosis occurring in 8.0% (5/62) patients at a mean time of 6.3 months after stenting. Conclusions Our data suggest that stenting may be a promising therapeutic option for IIH with cerebral venous sinus stenosis of non thrombotic, non external compression . The majority of patients may get longer-term positive outcomes with stenting.