Venous Sinus Stenting for Idiopathic Intracranial Hypertension

Abstract

Idiopathic intracranial hypertension (IIH), historically termed pseudotumor cerebri, is a poorly understood entity characterized by an increase in intracranial pressures (ICP) without a known cause. Patients often present with headaches, visual disturbances and photophobia, occasionally tinnitus, nausea, and vomiting, and most have objective changes in vision. The term benign intracranial hypertension is misleading as papilledema may be present in up to 95% of patients. This disease most commonly occurs in females and obese individuals, with reported female to male ratios ranging from 4:1 to 15:1, and the frequency of obesity in patients with IIH range from 71% to 94%. IIH continues to be a diagnosis of exclusion, with a poorly understood pathogenesis. Despite few advances in the understanding of the causes of IIH, new treatment modalities have evolved with the advent of endovascular stenting that, in select patients, can lead to improvement in symptoms.