Endovascular stenting of the superior sagittal sinus to alleviate venous compression caused by a parasagittal meningioma. Issue 4 (5th April 2019)

• Record Type: Journal Article
• Authors: Entezami, Pouya; Gooch, M Reid; Dalfino, John
• Is Part Of: BMJ case reports. Volume 12:Issue 4(2019)
• Publication Date: 2019-04-05
• Subjects: neurosurgery -- interventional radiology -- coma and raised intracranial pressure -- hydrocephalus -- neuroimaging; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-227935
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Idiopathic intracranial hypertension (IIH) is a challenging disease with unclear pathophysiology. Recognition of venous sinus stenting to improve intracranial pressure is increasing. We present a 56-year-old man diagnosed with IIH. A parasagittal meningioma abutting the sagittal sinus causing venous compression was found. Venous sinus stenting via endovascular approach using a WALLSTENT was performed. Intravascular pressures recorded after stenting demonstrated resolution of the pressure gradient. The patient had no complications from the procedure and reported substantial symptomatic improvement. Subsequent ophthalmologic exam demonstrated resolution of the bilateral papilledema noted prior to stenting. Endovascular treatment of venous sinus stenosis in the treatment of IIH is an emerging technique. Treatment of venous compromise due to a mass lesion with stenting is a rarely described concept. For our patient, endovascular stenting was the primary treatment modality, allowing the tumour to be followed with serial imaging.