Endovascular correction of an infantile intracranial venous outflow obstruction: Case report

Maryam Soltanolkotabi, Shahram Rahimi, Michael C. Hurley, Robin M. Bowman, Eric J. Russell, Sameer A. Ansari, Ali Shaibani*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

The authors report on the case of a 7-year-old boy who presented with a reduced level of activity, macrocephaly, prominent scalp veins, and decreased left-sided visual acuity. Imaging workup demonstrated generalized cerebral volume loss, bilateral chronic subdural hematomas, absent left sigmoid sinus, hypoplastic left transverse sinus, and severe focal weblike stenosis of the right sigmoid sinus. Right sigmoid sinus angioplasty and stent insertion was performed, with an immediate reduction in the transduced intracranial venous pressure gradient across the stenosis (from 22 to 3 mm Hg). Postprocedural diminution of prominent scalp and forehead veins and spinal venous collateral vessels was followed by a progressive improvement in visual acuity and physical activity over a 1-year follow-up period, supporting the efficacy of angioplasty and stent insertion in intracranial venous outflow obstruction. There are multiple potential causes of intracranial venous hypertension in children. Development of dural sinus stenosis in infancy may be one such cause, mimicking the clinical presentation of other causes such as vein of Galen malformations. This condition can be ameliorated by early endovascular revascularization.

Original languageEnglish (US)
Pages (from-to)660-663
Number of pages4
JournalJournal of Neurosurgery: Pediatrics
Volume12
Issue number6
DOIs
StatePublished - Dec 1 2013

Keywords

  • Intracranial angioplasty/stenting
  • Intracranial sigmoid sinus stenosis
  • Intracranial venous outflow obstruction
  • Macrocephaly
  • Vascular disorders

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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