【摘要】 目的评价脑静脉窦支架成形术治疗特发性颅内压增高（IIH）伴双侧横窦狭窄的安全性和有效性。方法对5例确诊为IIH伴双侧横窦狭窄并行支架成形术患者进行2年术后随访。患者均接受全脑血管造影,脑静脉内跨窦狭窄处微导管测压,术前和术后腰椎穿刺脑脊液测压,并行眼底照相、光学相干断层扫描评估视神经乳头水肿情况。随访期间观察患者临床症状变化,脑血管造影或CT静脉成像（CTV）复查脑静脉窦及支架情况。结果1例为优势侧横窦内源性狭窄,4例为优势侧横窦外源性狭窄。脑静脉窦支架成形术后跨狭窄病变压力梯度由术前平均（22.20±5.05）mmHg降至术后平均（1.40±0.75）mmHg,腰穿脑脊液压力由术前平均（322.0±37.20）mmH₂O降至术后平均（162.00±13.19）mmH₂O。术后头痛、头晕、视力下降、耳鸣、复视症状均明显改善或缓解,视神经乳头水肿均明显减轻。随访2年,所有症状均缓解,无复发。影像学检查提示支架形态良好,未见支架内或临近部位再狭窄。结论脑静脉窦支架成形术治疗IIH伴双侧横窦狭窄安全、有效,但需要进一步大样本、随机对照研究。更多还原

【Abstract】 Objective To evaluate the safety and efficacy of cerebral venous sinus stenting in treating idiopathic intracranial hypertension（IIH）with bilateral transverse sinus stenosis.Methods Five patients diagnosed with IIH with bilateral transverse sinus stenosis undergoing stenting were followed up for two years.All patients underwent cerebral angiography,intracerebral microcatheter manometry of the cerebral venous sinus stenosis,cerebrospinal fluid manometry by lumbar puncture,and papilledema assessment by fundus photography and optical coherence tomography before and after stenting.During follow-up,the changes in clinical symptoms were observed,cerebral venous sinus and stenting were reviewed by cerebral angiography or CT venography.Results One patient had intrinsic stenosis of the dominant transverse sinus,and four patients had extrinsic stenosis.After cerebral venous sinus stenting,the trans-stenotic lesion pressure gradient decreased from 22.20±5.05 mmHg to 1.40±0.75 mmHg,and the cerebrospinal fluid pressure of lumbar puncture reduced from 322.0±37.20 mmH₂O to 162.00±13.19 mmH₂O.Postoperatively,the headache,dizziness,decreased visual acuity,tinnitus,and diplopia were significantly improved or relieved,as were papilledema.All symptoms were relieved with no recurrence at two years of follow-up.Imaging studies suggested a well-formed stent with no restenosis in or adjacent to it.Conclusion Cerebral venous sinus stenting was safe and effective in treating IIH with bilateral transverse sinus stenosis,but further large sample and randomized controlled studies are needed.更多还原