Evolution of MRI Findings in Patients with Idiopathic Intracranial Hypertension after Venous Sinus Stenting.

Published on Oct 7, 2021in American Journal of Neuroradiology3.825
· DOI :10.3174/AJNR.A7311
Nebiyat F. Belachew , William Almiri + 10 AuthorsEike I. Piechowiak13
Estimated H-index: 13
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Abstract
BACKGROUND AND PURPOSE: null The correlation between imaging findings and clinical status in patients with idiopathic intracranial hypertension is unclear. We aimed to examine the evolution of idiopathic intracranial hypertension–related MR imaging findings in patients treated with venous sinus stent placement. null MATERIALS AND METHODS: null Thirteen patients with idiopathic intracranial hypertension (median age, 26.9 years) were assessed for changes in the CSF opening pressure, transstenotic pressure gradient, and symptoms after venous sinus stent placement. Optic nerve sheath diameter, posterior globe flattening and/or optic nerve protrusion, empty sella, the Meckel cave, tonsillar ectopia, the ventricles, the occipital emissary vein, and subcutaneous fat were evaluated on MR imaging before and 6 months after venous sinus stent placement. Data are expressed as percentages, medians, or correlation coefficients (r) with P values. null RESULTS: null Although all patients showed significant reductions of the CSF opening pressure (31 versus 21 cm H2O; P = .005) and transstenotic pressure gradient (22.5 versus 1.5 mm Hg; P = .002) and substantial improvement of clinical symptoms 6 months after venous sinus stent placement, a concomitant reduction was observed only for posterior globe involvement (61.5% versus 15.4%; P = .001), optic nerve sheath diameter (6.8  versus 6.1 mm; P  null CONCLUSIONS: null Most imaging findings persist long after normalization of intracranial pressure and clinical improvement. However, MR imaging findings related to the optic nerve may reflect treatment success.
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#1Wesley Chan (Nova Scotia Health Authority)H-Index: 3
#3Anuradha Mishra (Nova Scotia Health Authority)H-Index: 2
Last. Charles E. Maxner (Nova Scotia Health Authority)H-Index: 6
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Abstract Background Whether transverse venous sinus stenosis (TVSS) causes idiopathic intracranial hypertension (IIH) or is an effect of the increased intracranial pressures is controversial. The purpose of this study was to assess the feasibility of serial imaging in patients with IIH on medical management. Methods Patients found to have IIH and TVSS on contrast-enhanced magnetic resonance venography (CEMRV) were recruited in a prospective cohort study. Patients were medically managed and follo...
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#1Helen Wong (Dal: Dalhousie University)H-Index: 5
#2K. Sanghera (Dal: Dalhousie University)H-Index: 1
Last. Jai Jai Shiva Shankar (UM: University of Manitoba)H-Index: 21
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Purpose Although several studies have reported imaging findings associated with idiopathic intracranial hypertension (IIH), less is known about the correlation between imaging findings and IIH-related symptoms or signs. Our study aimed to determine if clinical features of IIH are correlated with magnetic resonance imaging (MRI) features.
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#1Robert M. Mallery (Brigham and Women's Hospital)H-Index: 8
#2Obeidurahman F. Rehmani (MEE: Massachusetts Eye and Ear Infirmary)H-Index: 1
Last. Grant T. LiuH-Index: 51
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OBJECTIVE: Revised diagnostic criteria for idiopathic intracranial hypertension (IIH) were proposed in part to reduce misdiagnosis of intracranial hypertension without papilledema (WOP) by using 3 or 4 MRI features of intracranial hypertension when a sixth nerve palsy is absent. This study was undertaken to evaluate the sensitivity and specificity of the MRI criteria and to validate their utility for diagnosing IIH in patients with chronic headaches and elevated opening pressure (CH + EOP), but ...
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#1Hale Zeynep Batur Caglayan (Gazi University)H-Index: 5
#2Murat UcarH-Index: 13
Last. Nil TokgözH-Index: 12
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BACKGROUND: This study aimed to identify the reversibility of MRI findings indicative of increased intracranial hypertension in idiopathic intracranial hypertension (IIH) patients after treatment. METHODS: This retrospective, observational study included demographic and clinical data from 10 patients with IIH and 10 controls. Brain MRI findings in IIH patients were recorded twice: once when patients had papilledema and again after resolution of papilledema. Neuroradiologists graded MRI findings ...
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#1Robert M. KweeH-Index: 24
#2Thomas C. Kwee (UMCG: University Medical Center Groningen)H-Index: 23
Abstract Objective To systematically review the potential value of MRI signs in the assessment of intracranial hypertension (IIH). Methods MEDLINE and Embase were systematically searched for original studies investigating the accuracy of MRI signs in diagnosing IIH. Methodologic quality of included studies was assessed. Sensitivity and specificity were pooled with a bivariate random-effects model. Results Twenty-one studies, comprising a total of 724 patients with IIH, were included. All studies...
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#1A. HedjoudjeH-Index: 1
#2A. PiveteauH-Index: 1
Last. D. San MillanH-Index: 2
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BACKGROUND AND PURPOSE: Transverse sinus stenosis can lead to pseudotumor cerebri syndrome by elevating the cerebral venous pressure. The occipital emissary vein is an inconstant emissary vein that connects the torcular herophili with the suboccipital veins of the external vertebral plexus. This retrospective study compares the prevalence and size of the occipital emissary vein in patients with pseudotumor cerebri syndrome with those in healthy control subjects to determine whether the occipital...
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BACKGROUND AND PURPOSE: The sensitivity of contrast-enhanced 3D-FLAIR has not been assessed in patients with idiopathic intracranial hypertension. The purpose of this study was to evaluate whether hyperintensity of the optic nerve/optic nerve head on contrast-enhanced 3D-FLAIR imaging is associated with papilledema in patients with idiopathic intracranial hypertension. MATERIALS AND METHODS: A retrospective review was conducted from 2012 to 2015 of patients with clinically diagnosed idiopathic i...
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#1Kyle M Fargen (Wake Forest University)H-Index: 31
#2Kenneth C. Liu (PSU: Pennsylvania State University)H-Index: 17
Last. R. Webster Crowley (Rush Medical College)H-Index: 32
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Introduction Although venous sinus stenting (VSS) has emerged as a promising treatment option for patients with idiopathic intracranial hypertension (IIH) and associated venous sinus stenosis, there is considerable ambiguity regarding patient selection criteria, treatment protocols, and management strategies. Methods An extensive literature review was performed to identify all reports of VSS in patients with IIH using PubMed. Recommendations for the selection and treatment of patients with IIH w...
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#1Fernando Yepes-Calderon (SC: University of Southern California)H-Index: 1
#2Marvin D. Nelson (SC: University of Southern California)H-Index: 50
Last. J. Gordon McComb (SC: University of Southern California)H-Index: 33
view all 3 authors...
The picture archiving and communications system (PACS) is currently the standard platform to manage medical images but lacks analytical capabilities. Staying within PACS, the authors have developed an automatic method to retrieve the medical data and access it at a voxel level, decrypted and uncompressed that allows analytical capabilities while not perturbing the system’s daily operation. Additionally, the strategy is secure and vendor independent. Cerebral ventricular volume is important for t...
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#1Kyle M Fargen (Wake Forest University)H-Index: 31
#2Alejandro M Spiotta (MUSC: Medical University of South Carolina)H-Index: 26
Last. Imran Chaudry (MUSC: Medical University of South Carolina)H-Index: 19
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Introduction Venous sinus stenting is a popular treatment strategy for patients with high venous sinus pressure gradients across a site of outflow obstruction. Little is known about the effect of anesthesia on venous sinus pressure measurements. Objective To compare venous manometry performed in patients under general anesthesia and while awake. Methods A prospective database was accessed to retrospectively identify patients who had undergone venous sinus stenting. Pressure gradients were compar...
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