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Advanced Neurology

REVIEW ARTICLE
Cerebral venous sinus stenting in idiopathic

intracranial hypertension

Persis Desai , Oluwaferanmi Dada , Jamie Warner , Kevin Pierre , and
1
1
2
1
Brandon Lucke-Wold *
3
1 College of Medicine, University of Florida, Gainesville, Florida, United States
2 Department of Radiology, University of Florida, Gainesville, Florida, United States
3 Department of Neurosurgery, University of Florida, Gainesville, Florida, United States

Abstract

Cerebral venous sinus stenting (CVSS) is a minimally invasive procedure using
endovascular stent placement to relieve elevated intracranial pressure secondary
to venous sinus stenosis. Increased venous sinus pressure secondary to stenosis is
commonly associated with elevated intracranial pressure without intracranial lesions
on imaging or idiopathic intracranial hypertension (IIH). While the etiology of IIH
remains unknown, stenosis of one or more of the dural sinuses has been implicated
as a possible underlying mechanism. The manifestations of IIH include headaches,
transient vision loss, pulsatile tinnitus, and neck pain. In this review, we discuss the
recent studies that have demonstrated the effectiveness of CVSS for patients with IIH
and also the indications, technical challenges, potential complications, and emerging
developments in CVSS.

*Corresponding author: Keywords: Cerebral venous sinus stenting; Idiopathic intracranial hypertension; Pulsatile
Brandon Lucke-Wold tinnitus; Venous sinus stenosis
(brandon.lucke-wold@
neurosurgery.ufl.edu)
Citation: Desai P, Dada O, Warner J,
et al., 2023, Cerebral venous sinus 1. Introduction
stenting in idiopathic intracranial
hypertension. Adv Neuro, 2(2): 284. Dural venous sinuses are channels between the endosteum and dura mater that
https://doi.org/10.36922/an.284
receive blood and cerebrospinal fluid (CSF) from the cerebral veins and arachnoid
Received: December 6, 2022 granulations, respectively. These sinuses drain through the internal jugular vein to the
Accepted: March 17, 2023 heart. The seven sinuses are the superior sagittal, inferior sagittal, straight, transverse,
sigmoid, cavernous, and superior petrosal sinuses [1,2] . The narrowing of any of these
Published Online: March 29, 2023
vessels, causing an obstruction of blood flow and CSF reuptake, is known as cerebral
Copyright: © 2023 Author(s). venous stenosis . Stenosis of one or more of these sinuses can result in hypertension
[3]
This is an Open-Access article
distributed under the terms of the proximal to the stenotic area and increased intracranial pressure (ICP). The increased
Creative Commons Attribution ICP further elevates the pressure within the stenotic vessel in a positive feedback
License, permitting distribution, loop . The placement of cerebral venous sinus stent (CVSS) to relieve pressure and
[3]
and reproduction in any medium,
provided the original work is interrupt this cycle is a viable treatment option for patients with idiopathic intracranial
properly cited. hypertension (IIH).
Publisher’s Note: AccScience
Publishing remains neutral with 2. Epidemiology and pathophysiology of IIH
regard to jurisdictional claims in
published maps and institutional IIH, also known as pseudotumor cerebri and benign intracranial hypertension, is
[4]
affiliations. characterized by an increase in ICP without a secondary cause . The prevalence of IIH

Volume 2 Issue 2 (2023) 1 https://doi.org/10.36922/an.284