Stenting of the Lateral Sinus in Idiopathic Intracranial Hypertension According to the Type of Stenosis
Stenting of the Lateral Sinus in Idiopathic Intracranial Hypertension According to the Type of Stenosis
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DOI：
10.1227/neu.0000000000001261
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发表时间：
2017-03-01
期刊：
影响因子：
4.8
通讯作者：
Houdart, Emmanuel
中科院分区：
文献类型：
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作者：
Lenck, Stephanie;Vallee, Fabrice;Houdart, Emmanuel
背景：在过去的十年中，侧窦狭窄支架已被用于治疗特发性高颅压。目的：本研究的目的是报道我们使用这种方法治疗特发性高颅压患者外源性或内在狭窄的结果。方法：我们回顾研究了2009年1月至2015年1月在我所接受侧窦支架治疗的特发性高颅压患者的临床、放射学和测压数据。平均体重指数为29 kg/m(2)，支架植入的中位年龄为33岁。外源性狭窄的患者比内源性狭窄的患者年轻。全麻患者测得的跨狭窄梯度低于局麻患者测得的。在所有病例中，支架植入术对乳头水肿和搏动性耳鸣都有效。17名报告头痛的患者发现，支架植入后头痛完全消失。2例无远期影响的并发症。结论：无论狭窄类型，支架置入术都是治疗高颅压症状的有效方法。在我们机构，当乙酰唑胺治疗被证明无效时，这种治疗已经取代了脑脊液的引流。
BACKGROUND: Over the past decade, stenting of lateral sinus stenosis has been used to treat idiopathic intracranial hypertension. Two types of stenoses have been identified: extrinsic and intrinsic.OBJECTIVE: The aim of this study was to report the results of our use of this procedure to treat patients with extrinsic or intrinsic stenoses in idiopathic intracranial hypertension.METHODS: We retrospectively studied clinical, radiological, and manometric data from patients with idiopathic intracranial hypertension who were treated at our institution between January 2009 and January 2015 by stenting of the lateral sinus.RESULTS: Data were studied from 19 women and 2 men. Average body mass index was 29 kg/m(2), and the median age at stenting was 33 years. Patients with extrinsic stenoses were younger than those with intrinsic stenoses. Transstenotic gradients measured with patients under general anesthesia were lower than those measured with patients under local anesthesia. In all cases, stenting was effective for papilledema and pulsatile tinnitus. Seventeen patients reporting headaches found that they disappeared completely after stenting. Two complications without long-term effects were reported.CONCLUSION: Irrespective of the type of stenosis, stenting of lateral sinus stenoses is an effective treatment for intracranial hypertension symptoms. At our institution, this treatment has replaced draining of cerebrospinal fluidwhen treatment with acetazolamide has proved to be ineffective.