Venous sinus stenting is a valuable treatment for fulminant idiopathic intracranial hypertension
Venous sinus stenting is a valuable treatment for fulminant idiopathic intracranial hypertension
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DOI：
10.1016/j.jocn.2014.10.012
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发表时间：
2015-04-01
影响因子：
2
通讯作者：
Rigamonti, Daniele
中科院分区：
文献类型：
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作者：
Elder, Benjamin D.;Goodwin, C. Rory;Rigamonti, Daniele
在过去的10年里，横窦支架作为一种治疗特发性颅内高压的方法越来越受欢迎。尽管在几个已报道的系列中显示了令人振奋的结果，但这些系列中的绝大多数患者都是在选择性的基础上接受治疗，而不是在暴发性疾病伴有急性视力恶化的情况下进行治疗。我们确定了2008-2012年间表现为严重急性视力丧失的4名患者，他们接受了紧急横窦支架置入术，并结合腰椎穿刺术或腰椎引流术作为治疗的桥梁。所有患者都表现为头痛，在最后一次随访时头痛稳定或有所改善。3名患者的部分或全部视力参数在支架植入后有所改善，而1名患者表现为严重的急性视力丧失和视盘苍白，尽管支架植入成功，但仍进展为失明。我们推测，她在病程中出现的时间太晚，病情不会好转。虽然暴发性特发性颅内高压的治疗仍然具有挑战性，但我们相信，横窦支架置入术结合暂时的脑脊液分流，在急性和适当的环境下是一种可行的治疗选择。爱思唯尔有限公司出版。
Over the past 10 years, transverse sinus stenting has grown in popularity as a treatment for idiopathic intracranial hypertension. Although promising results have been demonstrated in several reported series, the vast majority of patients in these series have been treated on an elective basis rather than in the setting of fulminant disease with acute visual deterioration. We identified four patients who presented with severe acute vision loss between 2008 and 2012 who were treated with urgent transverse sinus stenting with temporary cerebrospinal fluid (CSF) diversion with lumbar puncture or lumbar drain as a bridge to therapy. All patients presented with headache, and this was stable or had improved at last follow-up. Three patients had improvement in some or all visual parameters following stenting, whereas one patient who presented with severe acute vision loss and optic disc pallor progressed to blindness despite successful stenting. We hypothesize that she presented too late in the course of the disease for improvement to occur. Although the management of fulminant idiopathic intracranial hypertension remains challenging, we believe that transverse sinus stenting, in conjunction with temporary CSF diversion, represents a viable treatment option in the acute and appropriate setting. Published by Elsevier Ltd.