The correlation between intracranial pressure and venous sinus pressures changes after venous sinus stenting

医学 上矢状窦 静脉造影 SSS公司* 窦(植物学) 硬脑膜静脉窦 中心静脉压 外科 大脑假瘤 心脏病学 颅内压 血压 麻醉 内科学 心率 血栓形成 植物 生物
作者
Ankitha M Iyer,Jackson P Midtlien,Carol Kittel,Lucas A Klever,A Wiater,Emily Chang,Connor Margraf,Kyle M Fargen
出处
期刊:Journal of NeuroInterventional Surgery [BMJ]
卷期号:: jnis-022250
标识
DOI:10.1136/jnis-2024-022250
摘要

Background The pathophysiology of idiopathic intracranial hypertension (IIH) and other cerebral venous outflow disorders (CVD) has largely been unexplored. While a correlation between venous sinus pressure and opening pressure (OP) has been previously noted, there are limited data on this relationship in patients with prior venous sinus stenting (VSS). Methods A single center retrospective chart review was conducted on CVD patients who underwent diagnostic cerebral venography with manometry followed immediately by lateral decubitus lumbar puncture, from 2016 to 2024. Results 206 patients underwent 216 total procedures and were included. Among all patients, there was a moderate nearly one-to-one correlation between OP and torcular or superior sagittal sinus (SSS) pressures. Thirty-two patients underwent testing after having undergone VSS. Patients with previous VSS showed a significantly altered relationship between venous pressures and OP, whereby as venous sinus pressures increased, OP increased more gradually in previously stented patients compared with non-stented patients. For example, when OP was fixed at 21 mm Hg and body mass index at 30 kg/m 2 , predicted mean SSS pressure was 19.47 mm Hg in non-stented patients versus 16.91 mm Hg in stented patients. Conclusion This study confirmed a strong relationship between OP and venous sinus pressure in CVD patients. However, patients with previous VSS demonstrated an altered relationship with higher CSF pressures relative to venous pressures compared with naïve patients. This finding may have important clinical implications in the management of IIH patients.

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