ABSTRACT
OBJECTIVE: To explore the relationship of venous sinus stenosis and idiopathic intracranial hypertension (IIH) and to discuss the efficacy and strategy of endovascular treatment. METHODS: Balloon angioplasty and stent placement were performed in 24 IIH cases by lateral sinus stenosis. Mechanical thrombus maceration was performed before stent placing in 5 cases with suspected chronic dural sinus thrombosis. The clinical data of clinical presentations, intracranial pressure, pressure of lateral sinus, pressure gradient between distal and proximal lateral sinus stenosis, methods of treatment and therapeutic outcomes were retrospectively analyzed. RESULTS: Intracranial pressure dropped from (314 ± 56) mm H2O of pre-operation to (197 ± 31) mm H2O of post-operation. The post-treatment pressure gradient was obviously high ((159 ± 11) mm H2O) and a reduction was found ((95 ± 11) mm H2O). Headache in 16 cases, vision in 13 and papilledema in 10 were resolved or improved. There was no other permanent procedure-related morbidity. The patients were followed up for 2 - 19 months. And no in-stent restenosis occurred. CONCLUSION: Endovascular treatment is effective for IIH by venous sinus stenosis.
Subject(s)
Blood Vessel Prosthesis Implantation , Pseudotumor Cerebri/surgery , Sinus Thrombosis, Intracranial/surgery , Adult , Cerebral Angiography , Constriction, Pathologic , Female , Humans , Male , Middle Aged , Pseudotumor Cerebri/complications , Retrospective Studies , Sinus Thrombosis, Intracranial/complications , Stents , Young AdultABSTRACT
OBJECTIVE: To evaluate the correlation of collateral circulation with prognosis in patients with acute cerebral infarction. METHODS: A total of 260 patients with acute ischemic stroke within 1 week of symptom onset underwent digital subtraction angiogram (DSA). The National Institutes of Health Stroke Scale (NIHSS) scores were obtained at admission. And the Modified Rankin scores (mRS) were assessed at a 3-month follow-up. The follow-up data were acquired through clinic visits or telephone interviews. RESULTS: Among them, 86 were found to have intra- or extra-cranial culprit artery severe stenosis or occlusion. And 36 (75.00%) in 48 patients had collateral arterial circulation while 11 (28.64%) in 38 patients posterior circulation. There were statistical differences in the NIHSS scores at admission and favorite clinical outcome (mRS ≤ 2) at 3-month follow-up for patients with and without collateral circulation. CONCLUSION: DSA is the golden standard for the assessment of collateral circulation in patients with severe cerebral artery stenosis or occlusion. The prognosis is better in stroke patients with collateral circulation.
