Angioplasty and Stenting for Dural Venous Sinus Stenosis and Idiopathic Intracranial Hypertension / Pseudotumor Cerebri
Idiopathic intracranial hypertension (IIH), sometimes called by the older names benign intracranial hypertension (BIH) or pseudotumor cerebri (PTC), is a neurological disorder that is characterized by increased intracranial pressure (pressure around the brain) in the absence of a tumor or other disease.
The symptoms are headache, nausea, and vomiting, and sometimes pulsatile tinnitus (buzzing in the ears synchronous with the pulse), diplopia (double vision) and other visual symptoms. The increased pressure may lead to swelling of the optic disc in the eye. Swelling of the optic disc can progress to vision loss.
Older treatments of IIH included repeat lumbar punctures, medications that decrease production of CSF, surgical decompression of the optic nerve (optic nerve sheath fenestration), surgical shunting of the CSF from the spine to the abdomen (lumboperitoneal shunt), CSF shunting from the brain to the abdomen (ventriculoperitoneal shunt), and even CSF shunting from the brain to the heart (ventriculoatrial shunt).
New research demonstrates excellent clinical outcomes for the treatment of IIH by minimally invasive endovascular methods. These endovascular treatments involve placement of intracranial angioplasty balloons and stents across areas of stenosis (narrowing) within the cerebral venous circulation. These techniques can decrease the elevated pressure inside the head.
