title: Venous sinus pulsatility and the potential role of dural incompetence in idiopathic intracranial hypertension.
abstract: BACKGROUND
  Idiopathic intracranial hypertension (IIH) remains a poorly understood and therapeutically challenging disease. Enthusiasm has emerged for endovascular therapy with stent reconstruction of dural sinus narrowing; however, a complete understanding of the hydrodynamic dysequilibrium is lacking.
  
  
  OBJECTIVE
  To review and characterize catheter manometry findings including pulsatility changes within the venous sinuses in IIH.
  
  
  METHODS
  Cases of venous sinus stent implantation for IIH were retrospectively reviewed.
  
  
  RESULTS
  Three cases of venous sinus stent implantation for treatment of IIH are reported. All cases demonstrated severe narrowing (>70%) within the transverse sinus and a high pressure gradient across the lesion (>30 mm Hg). Stent implantation resulted in pulsatility attenuation, correction of pressure gradient, and improvement of flow.
  
  
  CONCLUSIONS
  We report the finding of high venous sinus pulsatility attenuation after stent implantation for dural sinus narrowing and propose the hypothesis that this finding is a marker of advanced dural sinus incompetence. This characteristic may be useful in identifying patients who would benefit from endovascular stent remodeling.
authors.affiliation: Department of Neurology, Medical College of Wisconsin and Froedtert Hospital, Milwaukee, Wisconsin 53226, USA.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Lazzaro
authors.forename: Ziad
authors.initials: Z
authors.lastname: Darkhabani
authors.forename: Bernd F
authors.initials: BF
authors.lastname: Remler
authors.forename: Sang H
authors.initials: SH
authors.lastname: Hong
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wolfe
authors.forename: Osama O
authors.initials: OO
authors.lastname: Zaidat
authors.forename: Brian-Fred
authors.initials: BF
authors.lastname: Fitzsimmons
mesh_terms: D015901:Angiography, Digital Subtraction; D003251:Constriction, Pathologic / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D018810:Magnetic Resonance Angiography; D011559:Pseudotumor Cerebri / Q000503:physiopathology* / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D054064:Transverse Sinuses; D016896:Treatment Outcome; D014690:Venous Pressure / Q000502:physiology*