Venous sinus stenting in idiopathic intracranial hypertension: a safer surgical approach?

PURPOSE OF REVIEW: The purpose is to summarize treatment strategies in idiopathic intracranial hypertension (IIH), a potentially sight-threatening disease, with a focus on the most current outcome data for venous sinus stenting.

RECENT FINDINGS: Historically, the primary treatment options for medically refractory IIH consisted of either optic nerve sheath fenestration or cerebrospinal fluid diversion procedures. The visual outcomes of these procedures are favorable, though they tend to be associated with a high rate of complication and failure. Recent trials suggest that venous sinus stenting offers both comparable rates of efficacy - with improved papilledema in 97% of patients, resolved headache in 83%, and improved visual acuity in 78% - and improved safety and reliability relative to older surgical techniques.

SUMMARY: Patients whose sight is threatened by medically refractory IIH must often consider invasive procedures to control their disease. Venous sinus stenting may offer equal efficacy and lower failure and complication rates than traditional surgical approaches such as optic nerve sheath fenestration and cerebrospinal fluid diversion.