Venous Sinus Stenting for Idiopathic Intracranial Hypertension: A Report of Two Cases

Idiopathic intracranial hypertension (IIH) is characterized by an elevated intracranial pressure of unknown cause, which can lead to severe and sometimes irreversible visual impairment. Recently, venous sinus stenting (VSS) has emerged as an alternative treatment option for IIH. Here, we report two patients with IIH who successfully underwent VSS in the transverse sinus and displayed rapid improvement in visual symptoms. Two young women presented with progressive visual symptoms of papilledema. The cerebrospinal fluid (CSF) opening pressures were elevated higher than 40 cmH₂O. Magnetic resonance venography demonstrated stenosis of the transverse sinuses. Intravascular ultrasonography demonstrated focal extrinsic narrowing of the sinuses. Dilatation of the stenotic sinuses using self-expanding open-cell stents resolved the trans-stenotic pressure gradients and lowered the CSF pressure. Visual symptoms and papilledema improved immediately after the procedures. VSS could be a useful treatment option for IIH with rapidly progressive visual impairment.