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

Belachew, N. F.; Almiri, W.; Encinas, R.; Hakim, A.; Baschung, S.; Kaesmacher, J.; Dobrocky, T.; Schankin, C. J.; Abegg, M.; Piechowiak, E. I.; Raabe, A.; Gralla, J.; Mordasini, P. (2021). Evolution of MRI Findings in Patients with Idiopathic Intracranial Hypertension after Venous Sinus Stenting. AJNR. American journal of neuroradiology, 42(11), pp. 1993-2000. American Society of Neuroradiology 10.3174/ajnr.A7311

[img] Text
Kaesmacher_Evolution_of_MRI.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (1MB) | Request a copy

BACKGROUND AND PURPOSE

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.

MATERIALS AND METHODS

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.

RESULTS

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 < .001), and subcutaneous neck fat (8.9  versus 7.4 mm; P = .001). Strong correlations were observed between decreasing optic nerve sheath diameters and improving nausea/emesis (right optic nerve sheath diameter, r =  0.592, P = .033; left optic nerve sheath diameter, r = 0.718, P = .006), improvement of posterior globe involvement and decreasing papilledema (r = 0.775, P = .003), and decreasing occipital emissary vein diameter and decreasing headache frequency (r = 0.74, P = .035). Decreasing transstenotic pressure gradient at 6 months strongly correlated with decreasing empty sella (r = 0.625, P = .022) and regressing cerebellar ectopia (r = 0.662, P = .019).

CONCLUSIONS

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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Belachew, Nebiyat Filate; Almiri, William; Encinas, Rubén; Hakim, Arsany; Kaesmacher, Johannes; Dobrocky, Tomas; Schankin, Christoph Josef; Abegg, Mathias; Piechowiak, Eike Immo; Raabe, Andreas; Gralla, Jan and Mordasini, Pasquale

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1936-959X

Publisher:

American Society of Neuroradiology

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

05 Nov 2021 08:28

Last Modified:

29 Nov 2021 16:14

Publisher DOI:

10.3174/ajnr.A7311

PubMed ID:

34620591

BORIS DOI:

10.48350/160045

URI:

https://boris.unibe.ch/id/eprint/160045

Actions (login required)

Edit item Edit item
Provide Feedback