Abstract:
Idiopathic intracranial hypertension (IIH) is increased intracranial pressure without a known cause. Dural venous sinus stenting (DVSS) is a relatively new intervention for treatment of IIH refractory to medical therapy and lifestyle modifications. In this review, we outline various hypotheses of IIH pathogenesis and describe the role of venous sinus stenosis and the technical details of DVSS. We also present a summary and critique of the available evidence describing the outcomes of DVSS in IIH and review the evidence-based guidelines for this procedure. We conclude that, although many studies have shown generally favorable outcomes of DVSS in patients with IIH, most have serious limitations, the most common one being paucity of pre- and postprocedure ophthalmological data. Thus, there is not enough available evidence to conclude whether DVSS is an effective procedure for treatment of IIH. We also present the most commonly used indications for DVSS as described in the literature and stress the importance of neuro-ophthalmological assessment before and after the procedure to monitor response and potential complications.
摘要:
特发性颅内高压(IIH)是无已知原因的颅内压升高。硬脑膜静脉窦支架置入术(DVS)是一种相对较新的干预措施,用于治疗药物治疗和生活方式改变难以治疗的IIH。在这次审查中,我们概述了IIH发病机制的各种假设,并描述了静脉窦狭窄的作用和DVS的技术细节.我们还对描述IIH中DVSS结果的现有证据进行了总结和批评,并回顾了该程序的循证指南。我们的结论是,尽管许多研究表明,IIH患者的DVS通常具有良好的预后,大多数都有严重的局限性,最常见的是术前和术后眼科数据匮乏。因此,没有足够的现有证据来断定DVS是否是治疗IIH的有效方法.我们还提出了文献中描述的DVSS最常用的适应症,并强调在手术前后进行神经眼科评估以监测反应和潜在并发症的重要性。