Venous sinus stenting lowers the intracranial pressure in patients with idiopathic intracranial hypertension.
Venous sinus stenting lowers the intracranial pressure in patients with idiopathic intracranial hypertension.
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DOI：
10.1136/neurintsurg-2018-014032
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发表时间：
2019-03
影响因子：
4.8
通讯作者：
Dinkin MJ
中科院分区：
文献类型：
--
作者：
Patsalides A;Oliveira C;Wilcox J;Brown K;Grover K;Gobin YP;Dinkin MJ
本文报道了50例特发性高颅压患者静脉窦支架置入术(VSS)前后脑脊液开放压(CSF-OP)的测定结果。治疗前3个月和治疗后3个月分别用脊椎抽吸法测定脑脊液-OP。所有数据都是前瞻性收集的，包括患者人口统计学、体重(Kg)、体重指数(BMI)、乙酰唑胺日剂量(Mg)、操作细节、并发症、静脉窦压力(Mm Hg)、跨狭窄压力梯度(Mm Hg)、横窦对称性和静脉窦狭窄类型。治疗前平均37 cm H2O(25~77)，治疗后平均20.2 cm H2O(10~36)，平均减少16.8 cm H2O(P<0.01)。40/50例患者治疗后脑脊液-OP<25 cm H2O。平均每日剂量由950 mg降至30 0 mg(P<0.0 1)。无患者需要在VSS后3个月增加乙酰唑胺剂量。治疗前平均体重95.4 4 kg，平均体重指数35.4 1。随访3个月，体重平均增加1.1BMI kg，体重指数平均增加0.35 (P=0.03)。我们提供的证据表明，与乙酰唑胺的使用或体重减轻无关，特发性高颅压患者VSS后3个月的脑脊液-OP水平显著降低。
We report the cerebrospinal fluid opening pressure (CSF-OP) measurements obtained before and after venous sinus stenting (VSS) in 50 patients with idiopathic intracranial hypertension. The CSF-OP was measured with a spinal tap 3 months before and 3 months after treatment. All data were prospectively collected and included patient demographics, weight (kg), body mass index (BMI), acetazolamide daily dosage (mg), procedural details, complications, venous sinus pressures (mm Hg), trans-stenotic pressure gradient (mm Hg), transverse sinus symmetry, and type of venous sinus stenosis. The average pretreatment CSF-OP was 37 cm H2O (range 25–77) and the average post-treatment CSF-OP was 20.2 cm H2O (range 10–36), with an average reduction of 16.8 cm H2O (P<0.01). The post-treatment CSF-OP was less than 25 cm H2O in 40/50 patients. The average acetazolamide daily dose decreased from 950 mg to 300 mg at the time of 3-month follow-up (P<0.01). No patient required an increase in acetazolamide dose 3 months after VSS. The average weight before treatment was 95.4 kg with an average BMI of 35.41. There was an average increase in body weight of 1.1 kg at the 3-month follow-up with an average increase in BMI of 0.35 (P=0.03). We provide evidence that there is a significant decrease in CSF-OP in patients with idiopathic intracranial hypertension 3 months after VSS, independent of acetazolamide usage or weight loss.
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