• Marc A Lazzaro, Ziad Darkhabani, Bernd F Remler, Sang H Hong, Thomas J Wolfe, Osama O Zaidat, and Brian-Fred Fitzsimmons.
• Department of Neurology, Medical College of Wisconsin and Froedtert Hospital, Milwaukee, Wisconsin 53226, USA.
• Neurosurgery. 2012 Oct 1;71(4):877-83.

BackgroundIdiopathic intracranial hypertension (IIH) remains a poorly understood and therapeutically challenging disease. Enthusiasm has emerged for endovascular therapy with stent reconstruction of dural sinus narrowing; however, a complete understanding of the hydrodynamic dysequilibrium is lacking.ObjectiveTo review and characterize catheter manometry findings including pulsatility changes within the venous sinuses in IIH.MethodsCases of venous sinus stent implantation for IIH were retrospectively reviewed.ResultsThree cases of venous sinus stent implantation for treatment of IIH are reported. All cases demonstrated severe narrowing (>70%) within the transverse sinus and a high pressure gradient across the lesion (>30 mm Hg). Stent implantation resulted in pulsatility attenuation, correction of pressure gradient, and improvement of flow.ConclusionWe report the finding of high venous sinus pulsatility attenuation after stent implantation for dural sinus narrowing and propose the hypothesis that this finding is a marker of advanced dural sinus incompetence. This characteristic may be useful in identifying patients who would benefit from endovascular stent remodeling.

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