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Gaudioso P, Biancoli E, Battistuzzi V, Concheri S, Saccardo T, Franchella S, Contro G, Taboni S, Zanoletti E, Causin F, Nico L, Gabrieli JD, Maroldi R, Nicolai P, Ferrari M. A Pathophysiological Approach to Spontaneous Orbital Meningoceles: Case Report and Systematic Review. J Pers Med 2024; 14:465. [PMID: 38793047 PMCID: PMC11122061 DOI: 10.3390/jpm14050465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 03/30/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Spontaneous orbital cephaloceles are a rare condition. The purpose of this study is to provide a description of a clinical case and to carry out a systematic literature review. METHODS A systematic review of the English literature published on the Pubmed, Scopus, and Web of Science databases was conducted, according to the PRISMA recommendations. RESULTS A 6-year-old patient was admitted for right otomastoiditis and thrombosis of the sigmoid and transverse sinuses, as well as the proximal portion of the internal jugular vein. Radiological examinations revealed a left orbital mass (22 × 14 mm) compatible with asymptomatic orbital meningocele (MC) herniated from the superior orbital fissure (SOF). The child underwent a right mastoidectomy. After the development of symptoms and signs of intracranial hypertension (ICH), endovascular thrombectomy and transverse sinus stenting were performed, with improvement of the clinical conditions and reduction of the orbital MC. The systematic literature review encompassed 29 publications on 43 patients with spontaneous orbital MC. In the majority of cases, surgery was the preferred treatment. CONCLUSIONS The present case report and systematic review highlight the importance of ICH investigation and a pathophysiological-oriented treatment approach. The experiences described in the literature are limited, making the collection of additional data paramount.
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Affiliation(s)
- Piergiorgio Gaudioso
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Oncology and Immunology (PhD Program), Department of Surgery Oncology and Gastroenterology (DiSCOG), University of Padova, 35128 Padova, Italy
| | - Elia Biancoli
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Veronica Battistuzzi
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Stefano Concheri
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Tommaso Saccardo
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Sebastiano Franchella
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Giacomo Contro
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, 25123 Brescia, Italy
| | - Stefano Taboni
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Artificial Intelligence in Medicine and Innovation in Clinical Research and Methodology (PhD Program), Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Francesco Causin
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Section of Neuroradiology, Department of Diagnostic Imaging and Interventional Radiology, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (F.C.); (L.N.); (J.D.G.)
| | - Lorena Nico
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Section of Neuroradiology, Department of Diagnostic Imaging and Interventional Radiology, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (F.C.); (L.N.); (J.D.G.)
| | - Joseph Domenico Gabrieli
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Section of Neuroradiology, Department of Diagnostic Imaging and Interventional Radiology, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (F.C.); (L.N.); (J.D.G.)
| | - Roberto Maroldi
- Division of Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy;
| | - Piero Nicolai
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
| | - Marco Ferrari
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, “Azienda Ospedale Università di Padova”, University of Padua, 35128 Padua, Italy; (P.G.); (E.B.); (V.B.); (S.C.); (T.S.); (S.F.); (G.C.); (S.T.); (E.Z.); (P.N.)
- Unit of Otorhinolaryngology—Head and Neck Surgery, Azienda Ospedale Università Padova, 35128 Padua, Italy
- Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, ON M5G 2C4, Canada
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Pandey A, Schreiber C, Garton ALA, Jung B, Goldberg JL, Kocharian G, Carnevale JA, Boddu SR. Future Directions and Innovations in Venous Sinus Stenting. World Neurosurg 2024; 184:387-394. [PMID: 38590072 DOI: 10.1016/j.wneu.2023.12.128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 04/10/2024]
Abstract
This review explores the future role of venous sinus stenting (VSS) in the management of idiopathic intracranial hypertension and pulsatile tinnitus. Despite its favorable safety profile and clinical outcomes compared with traditional treatments, VSS is not yet the standard of care for these conditions, lacking high-level evidence data and guidelines for patient selection and indications. Current and recently completed clinical trials are expected to provide data to support the adoption of VSS as a primary treatment option. Additionally, VSS shows potential in treating other conditions, such as dural arteriovenous fistula and cerebral venous sinus thrombosis, and it is likely that the procedure will continue to see an expansion of its approved indications. The current lack of dedicated venous stenting technology is being addressed with promising advancements, which may improve procedural ease and patient outcomes. VSS also offers potential for expansion into modulation of brain electrophysiology via endovascular routes, offering exciting possibilities for neurodiagnostics and treatment of neurodegenerative disorders.
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Affiliation(s)
- Abhinav Pandey
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Craig Schreiber
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Andrew L A Garton
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Brandon Jung
- Human Health Major (BA), Emory University, Atlanta, Georgia, USA
| | - Jacob L Goldberg
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Gary Kocharian
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Joseph A Carnevale
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Srikanth R Boddu
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA.
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Asi KW, Cameron BH, Friedman ER, Radabaugh JP, Citardi MJ, Luong AU, Yao WC. Dural sinus narrowing in patients with spontaneous anterior skull base cerebrospinal fluid leak. Laryngoscope Investig Otolaryngol 2023; 8:621-626. [PMID: 37342101 PMCID: PMC10278120 DOI: 10.1002/lio2.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 06/22/2023] Open
Abstract
Objectives Current evidence suggests a link between idiopathic intracranial hypertension (IIH) and spontaneous cerebrospinal fluid (sCSF) leak, as well as between IIH and dural venous sinus (DVS) narrowing. However, there are limited data linking DVS narrowing and sCSF leak. This study aims to determine the prevalence of DVS narrowing in patients with sCSF leak. Methods A retrospective review of all patients with sCSF leak that presented to a tertiary academic center from 2008 to 2019. Preoperative imaging was independently reviewed by two neuroradiologists to evaluate for DVS narrowing. Available literature was used to estimate the prevalence of DVS narrowing in the general population to allow for comparison. Data were analyzed using Exact binomial test. Results Analysis of 25 patients with appropriate imaging revealed the majority were women (21/25, 84%) with a mean age of 51.89 years (SD 13.96). The majority of these patients were found to have narrowing of the DVS (20/25, 80%). In patient with sCSF leaks, there was a significantly higher proportion of patients with DVS narrowing compared with published literature examining this condition in the general population (80% vs. 40%, CI 0.59-0.93, p < .001). Conclusion The prevalence of DVS narrowing in patients with sCSF leaks is substantial and likely greater than the general population. Moreover, there appears to be narrowing in most patients with sCSF leak. Preoperative radiological evaluation of the DVS using MR venography may be useful in patients with sCSF leaks as DVS stenosis may be an underdiagnosed etiology. Further study is needed to evaluate this. Level of Evidence IV.
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Affiliation(s)
- Karim W. Asi
- Department of Otorhinolaryngology‐Head and Neck Surgery, McGovern Medical SchoolThe University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Brian H. Cameron
- Department of Otorhinolaryngology‐Head and Neck Surgery, McGovern Medical SchoolThe University of Texas Health Science Center at HoustonHoustonTexasUSA
| | | | | | - Martin J. Citardi
- Department of Otorhinolaryngology‐Head and Neck Surgery, McGovern Medical SchoolThe University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Amber U. Luong
- Department of Otorhinolaryngology‐Head and Neck Surgery, McGovern Medical SchoolThe University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - William C. Yao
- Department of Otorhinolaryngology‐Head and Neck Surgery, McGovern Medical SchoolThe University of Texas Health Science Center at HoustonHoustonTexasUSA
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Buchowicz B, Chen BS, Bidot S, Bruce BB, Newman NJ, Saindane AM, Levy JM, Biousse V. Prediction of Postoperative Risk of Raised Intracranial Pressure After Spontaneous Skull Base Cerebrospinal Fluid Leak Repair. J Neuroophthalmol 2021; 41:e490-e497. [PMID: 33734152 PMCID: PMC8435037 DOI: 10.1097/wno.0000000000001118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A relationship between idiopathic intracranial hypertension and spontaneous skull base cerebrospinal fluid (CSF) leaks has been proposed, by which CSF leak decreases intracranial pressure (ICP) and masks the symptoms and signs of elevated ICP. These patients are at risk of developing papilledema, symptoms of elevated ICP, or a recurrent CSF leak after CSF leak repair. The objective of this study was to assess whether radiographic signs of raised ICP on preoperative magnetic resonance or computed venography (MRI or CTV) are predictors of postoperative papilledema, recurrence of CSF leak, or need for CSF shunt surgery. METHODS We performed a retrospective review of systematically collected demographics, fundus examination, and presurgical brain MRI and magnetic resonance venography/computed tomography venography (MRV/CTV) in patients seen at 1 institution between 2013 and 2019 with spontaneous skull base CSF leak repair. Patients were divided into 2 groups depending on whether they developed papilledema, recurrent CSF leak, or required CSF shunting (Group 1) or not (Group 2). RESULTS Fifty-seven patients were included, among whom 19 were in Group 1. There was no difference in demographic characteristics or clinical features between patients in Group 1 and Group 2. Controlling for other imaging features, bilateral transverse venous sinus stenosis (TVSS) on preoperative imaging increased the odds of being in Group 1 by 4.2 times (95% confidence interval [CI], 1.04-21.2, P = 0.04), optic nerve tortuosity decreased the odds of being in Group 1 by 8.3 times (95% CI: 1.4-74.6, P = 0.02). CONCLUSION Imaging of the intracranial venous system with MRV or CTV is warranted before repair of spontaneous CSF leak, as bilateral TVSS is an independent risk factor for postoperative papilledema, CSF leak recurrence, or need for a CSF shunting procedure.
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Affiliation(s)
- Bryce Buchowicz
- Departments of Ophthalmology (BB, BSC, BBB, NJN, VB); Pathology (SB); Epidemiology (BBB); Neurology (BBB, NJN, VB); Neurological Surgery (NJN); Radiology and Imaging Sciences (AMS); and Otolaryngology- Head and Neck Surgery (JML), Emory University School of Medicine, Atlanta, Georgia
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Lenck S, Nouet A, Shotar E, Abi Jaoudé S, Nicholson P, Premat K, Corcy C, Boch AL, Sourour NA, Tankere F, Carpentier A, Clarençon F. Transverse sinus stenting without surgical repair in idiopathic CSF rhinorrhea associated with transverse sinus stenoses: a pilot study. J Neurosurg 2021:1-7. [PMID: 34624855 DOI: 10.3171/2021.5.jns21894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/07/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Based on their clinical and radiological patterns, idiopathic CSF rhinorrhea and idiopathic intracranial hypertension can represent different clinical expressions of the same underlying pathological process. Transverse sinus stenoses are associated with both diseases, resulting in eventual restriction of the venous CSF outflow pathway. While venous sinus stenting has emerged as a promising treatment for idiopathic intracranial hypertension, its efficiency on idiopathic CSF leaks has not been very well addressed in the literature so far. The purpose of this study was to report the results of transverse sinus stenting in patients with spontaneous CSF rhinorrhea associated with transverse sinus stenoses. METHODS From a prospectively collected database, the authors retrospectively collected the clinical and radiological features of the patients with spontaneous CSF leakage who were treated with venous sinus stenting. RESULTS Five female patients were included in this study. Transverse sinus stenoses were present in all patients, and other radiological signs of idiopathic intracranial hypertension were present in 4 patients. The median transstenotic pressure gradient was 6.5 mm Hg (range 3-9 mm Hg). Venous stenting resulted in the disappearance of the leak in 4 patients with no recurrence and no subsequent meningitis during the follow-up (median 12 months, range 6-63 months). CONCLUSIONS According to the authors' results, venous sinus stenting may result in the disappearance of the leak in many cases of idiopathic CSF rhinorrhea. Larger comparative studies are needed to assess the efficiency and safety of venous stenting as a first-line approach in patients with spontaneous CSF rhinorrhea associated with transverse sinus stenoses.
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Affiliation(s)
- Stephanie Lenck
- 1Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Paris.,2GRC E-HTIC, Sorbonne University, Paris
| | - Aurelien Nouet
- 3Department of Neurosurgery, Groupe Hospitalier Pitié Salpêtrière, Paris, France
| | - Eimad Shotar
- 1Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Paris.,2GRC E-HTIC, Sorbonne University, Paris
| | - Samiya Abi Jaoudé
- 3Department of Neurosurgery, Groupe Hospitalier Pitié Salpêtrière, Paris, France
| | - Patrick Nicholson
- 4Department of Neuroradiology, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Kevin Premat
- 1Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Paris.,5Sorbonne Université, Paris; and
| | - Celine Corcy
- 1Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Paris
| | - Anne-Laure Boch
- 3Department of Neurosurgery, Groupe Hospitalier Pitié Salpêtrière, Paris, France
| | | | - Frederic Tankere
- 5Sorbonne Université, Paris; and.,6Department of Otolaryngology, Groupe Hospitalier Pitié Salpêtrière, Paris, France
| | - Alexandre Carpentier
- 3Department of Neurosurgery, Groupe Hospitalier Pitié Salpêtrière, Paris, France.,6Department of Otolaryngology, Groupe Hospitalier Pitié Salpêtrière, Paris, France
| | - Frederic Clarençon
- 1Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Paris.,6Department of Otolaryngology, Groupe Hospitalier Pitié Salpêtrière, Paris, France
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Labeyrie MA, Bedarida V, Vever U, Guedon A, Herman P, Verillaud B, Houdart E. Venous sinus stenting after repair of skull base spontaneous cerebrospinal fluid leaks: A single-center retrospective cohort series with case-control analysis. J Neuroradiol 2021; 49:164-168. [PMID: 34273358 DOI: 10.1016/j.neurad.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/24/2021] [Accepted: 07/05/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Management of idiopathic intracranial hypertension (IIH) is recommended after surgical repair of spontaneous cerebrospinal fluid leaks (sCSF-leaks) of the skull base for prevention of recurrence. PURPOSE To assess the feasibility of venous sinus stenting, a treatment commonly used for the treatment of IIH associated with intracranial venous sinus stenosis (VSS), after sCSF-leaks closure. MATERIALS AND METHODS A single-center cohort series of consecutive patients who underwent sCSF-leak closure was retrospectively analyzed. Stenting was considered either for leak recurrence or in prophylactic manner after repair in patients with VSS as confirmed by cerebral venous imaging. Leak recurrence, need for new repair or adjunctive treatment of IIH, meningitis, and stenting complications were determined at the last follow-up. Cases who had prophylactic stenting were compared to historical controls before stenting option. RESULTS Twenty-two patients had intracranial venous stenting after sCSF-leak closure. Their median age was 58 years (Q1=45; Q3=68), BMI=31 kg.m-2 (Q1=27; Q3=36), and female rate=85%. The overall rate of successful repair after stenting was 95% (95% CI = 87-100%) at a median follow-up of 2.4 years (Q1=1.2; Q3=3.3). Adjunctive treatment for IIH was needed in 4 patients (4/22, 18%) including 2 patients without leak recurrence. No meningitis, permanent morbidity or mortality was observed after stenting. Compared to 18 controls, cases had significantly less recurrence (P = 0.03), and a trend for less adjunctive treatment for IIH (P = 0.06). CONCLUSIONS Our study suggests that stenting might be a valid option for prevention of sCSF-leak recurrences after repair in patients with intracranial venous sinus stenosis.
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Affiliation(s)
- Marc-Antoine Labeyrie
- Interventional Neuroradiology department, Hôpital Lariboisière, Université de Paris, France.
| | - Vincent Bedarida
- Otorhinolaryngology department, Hôpital Lariboisière, Inserm U1141, Université de Paris, France
| | - Ursulla Vever
- Neurology department, Hôpital Lariboisière, Université de Paris, France
| | - Alexis Guedon
- Interventional Neuroradiology department, Hôpital Lariboisière, Université de Paris, France
| | - Philippe Herman
- Otorhinolaryngology department, Hôpital Lariboisière, Inserm U1141, Université de Paris, France
| | - Benjamin Verillaud
- Otorhinolaryngology department, Hôpital Lariboisière, Inserm U1141, Université de Paris, France
| | - Emmanuel Houdart
- Interventional Neuroradiology department, Hôpital Lariboisière, Université de Paris, France
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Labeyrie MA, Fantoni M, Vever U, Guedon A, Bonnin S, Bernat AL, Verillaud B, Houdart E. Intracranial venous sinus stenting for the treatment of lateral sinus stenoses: An analysis of 200 patients. Diagn Interv Imaging 2021; 102:619-627. [PMID: 34127434 DOI: 10.1016/j.diii.2021.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE The purpose of this study was to analyze the long-term efficacy and safety of intracranial venous sinus stenting in a large cohort of patients with any type of presentation of primary lateral venous sinus stenosis (VSS). MATERIALS AND METHODS A retrospective cohort study was performed including patients treated by venous sinus stenting for symptomatic VSS from 2012 to 2019. Successful primary resolution of symptoms without adjunctive treatment or recurrence, and complications after stenting were analyzed at the last follow-up time point. RESULTS Two-hundred patients were included. There were 14 men and 186 women with a mean age of 39±14 (SD) years (age range: 13-75 years). Presenting symptoms included venous pulsatile tinnitus in 168 patients (168/200; 84%), idiopathic intracranial hypertension in 100 patients (100/200; 50%) and/or spontaneous cerebrospinal fluid leak in 35 patients (35/200; 17%). The overall rate of successful primary resolution of any typical presenting symptoms was 79% (95% CI: 73-85%). This rate ranged from 74% to 93% depending on the symptom with no significant difference between patients with and those without idiopathic intracranial hypertension (P=0.08). Recurrence rate was 10% (95% CI: 6-14%). No death or permanent morbidity were observed during a median follow-up of 2.2 years (Q1, Q3: 1.4, 3.3; range: 1-7.7 years). CONCLUSION Our study shows that venous sinus stenting has a low morbidity and high success rate at long-term follow-up for the treatment of idiopathic intracranial hypertension, venous pulsatile tinnitus or spontaneous cerebrospinal fluid leak associated with VSS. The excellent safety suggests considering this treatment as first-line treatment when medical management is ineffective or poorly tolerated.
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Affiliation(s)
- Marc-Antoine Labeyrie
- Department of Interventional Neuroradiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université de Paris, 75010 Paris, France.
| | - Matteo Fantoni
- Department of Interventional Neuroradiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université de Paris, 75010 Paris, France
| | - Ursula Vever
- Department of Neurology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université de Paris, 75010 Paris, France
| | - Alexis Guedon
- Department of Interventional Neuroradiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université de Paris, 75010 Paris, France
| | - Sophie Bonnin
- Department of Neuroophtalmology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université de Paris, 75010 Paris, France
| | - Anne-Laure Bernat
- Department of Neurosurgery, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université de Paris, 75010 Paris, France
| | - Benjamin Verillaud
- Department of Otorhinolaryngology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris Université de Paris, 75010 Paris, France
| | - Emmanuel Houdart
- Department of Interventional Neuroradiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université de Paris, 75010 Paris, France
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Nussbaum LA, Schwarzrock CA, Burke EM, Torok CM, Nussbaum ES. CT cisternography to visualize epidermoid tumors for stereotactic radiosurgery treatment planning. J Clin Neurosci 2021; 89:91-96. [PMID: 34119301 DOI: 10.1016/j.jocn.2021.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/30/2021] [Accepted: 04/26/2021] [Indexed: 11/26/2022]
Abstract
The visualization of intracranial epidermoid tumors is often limited by difficulties associated with distinguishing the tumor from the surrounding cerebrospinal fluid using traditional computed tomography (CT) or magnetic resonance imaging (MRI) modalities. This report describes our experience using CT cisternography to visualize intracranial epidermoid tumors in three illustrative cases. CT cisternography of the epidermoid tumor provides more clarity and precision compared to traditional neuroimaging modalities. We demonstrate the feasibility of using CT cisternography to produce high-resolution images with well-defined tumor margins that can be used effectively for precise SRS treatment planning.
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Affiliation(s)
- Leslie A Nussbaum
- Department of Neurosurgery, National Brain Aneurysm & Tumor Center, United Hospital, 3033 Excelsior Blvd., Suite 495, Minneapolis, MN 55416, USA; John Naseff Cyberknife Center at United Hospital, Allina Health, 310 Smith Ave N #440, St. Paul, MN 55102, USA.
| | - Camille A Schwarzrock
- John Naseff Cyberknife Center at United Hospital, Allina Health, 310 Smith Ave N #440, St. Paul, MN 55102, USA
| | | | - Collin M Torok
- Midwest Radiology, 2355 Highway 36 West, Roseville, MN 55113, USA
| | - Eric S Nussbaum
- Department of Neurosurgery, National Brain Aneurysm & Tumor Center, United Hospital, 3033 Excelsior Blvd., Suite 495, Minneapolis, MN 55416, USA
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Bedarida V, Labeyrie M, Eliezer M, Saint‐Maurice J, Jourdaine C, Gargalas S, Herman P, Houdart E, Verillaud B. Association of spontaneous cerebrospinal fluid rhinorrhea with transverse venous sinus stenosis: a retrospective matched case‐control study. Int Forum Allergy Rhinol 2020; 10:1295-1299. [DOI: 10.1002/alr.22660] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 01/05/2023]
Affiliation(s)
- Vincent Bedarida
- Otorhinolaryngology Department Hôpital Lariboisière, Assistance Publique–Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale (National Institute of Health and Medical Research; INSERM) U1141, Université de Paris Paris France
| | - Marc‐Antoine Labeyrie
- Diagnostic and Interventional Neuroradiology Department Hôpital Lariboisière, Assistance Publique–Hôpitaux de Paris, Université de Paris Paris France
| | - Michael Eliezer
- Diagnostic and Interventional Neuroradiology Department Hôpital Lariboisière, Assistance Publique–Hôpitaux de Paris, Université de Paris Paris France
| | - Jean‐Pierre Saint‐Maurice
- Diagnostic and Interventional Neuroradiology Department Hôpital Lariboisière, Assistance Publique–Hôpitaux de Paris, Université de Paris Paris France
| | - Clément Jourdaine
- Otorhinolaryngology Department Hôpital Lariboisière, Assistance Publique–Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale (National Institute of Health and Medical Research; INSERM) U1141, Université de Paris Paris France
| | - Sergios Gargalas
- Diagnostic and Interventional Neuroradiology Department John Radcliffe Hospital Oxford UK
| | - Philippe Herman
- Otorhinolaryngology Department Hôpital Lariboisière, Assistance Publique–Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale (National Institute of Health and Medical Research; INSERM) U1141, Université de Paris Paris France
| | - Emmanuel Houdart
- Diagnostic and Interventional Neuroradiology Department Hôpital Lariboisière, Assistance Publique–Hôpitaux de Paris, Université de Paris Paris France
| | - Benjamin Verillaud
- Otorhinolaryngology Department Hôpital Lariboisière, Assistance Publique–Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale (National Institute of Health and Medical Research; INSERM) U1141, Université de Paris Paris France
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