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CASE REPORT
Endovascular stenting of the superior sagittal sinus to alleviate venous compression caused by a parasagittal meningioma
  1. Pouya Entezami1,
  2. M Reid Gooch2 and
  3. John Dalfino1
  1. 1 Department of Neurosurgery, Albany Medical Center, Albany, New York, USA
  2. 2 Neurological Surgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Pouya Entezami, entezap{at}amc.edu

Abstract

Idiopathic intracranial hypertension (IIH) is a challenging disease with unclear pathophysiology. Recognition of venous sinus stenting to improve intracranial pressure is increasing.

We present a 56-year-old man diagnosed with IIH. A parasagittal meningioma abutting the sagittal sinus causing venous compression was found. Venous sinus stenting via endovascular approach using a WALLSTENT was performed. Intravascular pressures recorded after stenting demonstrated resolution of the pressure gradient.

The patient had no complications from the procedure and reported substantial symptomatic improvement. Subsequent ophthalmologic exam demonstrated resolution of the bilateral papilledema noted prior to stenting. Endovascular treatment of venous sinus stenosis in the treatment of IIH is an emerging technique. Treatment of venous compromise due to a mass lesion with stenting is a rarely described concept. For our patient, endovascular stenting was the primary treatment modality, allowing the tumour to be followed with serial imaging.

  • neurosurgery
  • interventional radiology
  • coma and raised intracranial pressure
  • hydrocephalus
  • neuroimaging
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Footnotes

  • Contributors All authors have reviewed and approved the final version of this manuscript. Authors PE, MRG and JD managed this patient. All authors contributed to literature review, manuscript drafting and obtaining imaging.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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