Intracranial hypertension induced by internal jugular vein stenosis can be resolved by stenting
D. Zhou
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorCorresponding Author
R. Meng
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Correspondence: R. Meng and X. Ji, Xuanwu Hospital, Capital Medical University, Beijing 100053, China (tel.: +86 10 83198952; fax: +86 10 83154745; e-mail: [email protected] and [email protected]).Search for more papers by this authorX. Zhang
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorL. Guo
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorS. Li
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorW. Wu
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorJ. Duan
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorH. Song
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorY. Ding
Beijing Institute for Brain Disorders, Beijing, China
Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
Search for more papers by this authorCorresponding Author
X. Ji
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Correspondence: R. Meng and X. Ji, Xuanwu Hospital, Capital Medical University, Beijing 100053, China (tel.: +86 10 83198952; fax: +86 10 83154745; e-mail: [email protected] and [email protected]).Search for more papers by this authorD. Zhou
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorCorresponding Author
R. Meng
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Correspondence: R. Meng and X. Ji, Xuanwu Hospital, Capital Medical University, Beijing 100053, China (tel.: +86 10 83198952; fax: +86 10 83154745; e-mail: [email protected] and [email protected]).Search for more papers by this authorX. Zhang
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorL. Guo
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorS. Li
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorW. Wu
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorJ. Duan
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorH. Song
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Search for more papers by this authorY. Ding
Beijing Institute for Brain Disorders, Beijing, China
Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
Search for more papers by this authorCorresponding Author
X. Ji
Departments of Neurology, Neurosurgery, and Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
Beijing Institute for Brain Disorders, Beijing, China
Correspondence: R. Meng and X. Ji, Xuanwu Hospital, Capital Medical University, Beijing 100053, China (tel.: +86 10 83198952; fax: +86 10 83154745; e-mail: [email protected] and [email protected]).Search for more papers by this authorAbstract
Background and purpose
Idiopathic intracranial hypertension (IIH) is characterized by abnormally elevated intracranial pressure (ICP) without identifiable etiology. Recently, however, a subset of patients with presumed IIH have been found with isolated internal jugular vein (IJV) stenosis in the absence of intracranial abnormalities.
Methods
Fifteen consecutive patients were screened from 46 patients suspected as IIH and were finally confirmed as isolated IJV stenosis. The stenotic IJV was corrected with stenting when the trans-stenotic mean pressure gradient (∆MPG) was equal to or higher than 5.44 cmH2O. Dynamic magnetic resonance venography, computed tomographic venography and digital subtraction angiography of the IJV, ∆MPG, ICP, Headache Impact Test 6 and the Frisén papilledema grade score before and after stenting were compared.
Results
All the stenotic IJVs were corrected by stenting. ∆MPG decreased and the abnormal collateral veins disappeared or shrank immediately. Headache, tinnitus, papilledema and ICP were significantly ameliorated at 14 ± 3 days of follow-up (all P < 0.01). At 12 ± 5.6 months of outpatient follow-up, headache disappeared in 14 out of 15 patients (93.3%), visual impairments were recovered in 10 of 12 patients (83.3%) and tinnitus resolved in 10 out of 11 patients (90.9%). In 12 out of 15 cases, the Frisén papilledema grade scores declined to 1 (0–2). The stented IJVs in all 15 patients kept to sufficient blood flows on computed tomographic venography follow-up without stenting-related adverse events.
Conclusions
Non-thrombotic IJV stenosis may be a potential etiology of IIH. Stenting seems to be a promising option to address the issue of intracranial hypertension from the etiological level, particularly after medical treatment failure.
Supporting Information
| Filename | Description |
|---|---|
| ene13512-sup-0001-SupInfo.docxWord document, 47.6 KB | Table S1. 1. Baseline characteristics of patients with isolated non-thrombotic IJV stenosis. 2. Follow-up clinical characteristics of patients with isolated non-thrombotic IJV stenosis. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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