Venous Stenting for Idiopathic Intracranial Hypertension

Idiopathic intracranial hypertension is a syndrome affecting mostly obese women of childbearing age leading to symptoms and signs of elevated intracranial pressure including papilledema. Management includes weight loss and medications that reduce intracranial pressure, but when these conservative therapies fail, surgical intervention may be warranted to prevent potentially irreversible vision loss. Based upon an observed association between stenosis at the junction of the transverse and sigmoid venous sinuses, endovascular stenting of the stenotic region has emerged as a potential therapeutic option, alongside more established surgical interventions such as CSF shunt procedures and optic nerve sheath fenestration. In this chapter, we review the theoretical basis explaining the relationship between venous stenosis and idiopathic intracranial hypertension, and summarize the outcomes associated with this innovative treatment to date.