Skip to main content

Advertisement

SpringerLink
Log in

Endovascular stenting for cerebral venous sinus stenosis secondary to meningioma invasion

  • Interventional Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Introduction

Symptomatic intracranial hypertension (IH) due to venous outflow obstruction secondary to dural venous sinus (DVS) tumoral invasion affects up to 3% of intracranial meningioma patients. The literature regarding endovascular therapies of such patients is limited to a few case reports and a recent single-centre case series.

Purpose

We describe our single-centre experience of endovascular therapy in patients with clinically symptomatic IH secondary to DVS meningioma invasion.

Methods

We performed a retrospective review of clinical and radiological data of all patients with refractory IH and meningiomas invading the DVS who were referred for possible DVS venoplasty and stenting. Seven endovascular procedures in six female patients were done. Presumed secondarily induced lateral transverse sinus stenosis was also stented in four patients as part of the primary intervention.

Results

All patients experienced complete symptomatic resolution at 6-month follow-up. Five patients had no symptom recurrence over a mean follow-up period of 3.5 years. One patient with multiple meningiomas developed recurrent IH 2 years following stenting secondary to in-stent tumour re-invasion. This was re-stented with consequent 6 months post-retreatment symptomatic relief at the time of writing. No procedure-related complications occurred.

Conclusion

In the setting of DVS stenosis secondary to meningioma invasion, endovascular therapy is a safe and successful therapeutic option with promising mid-term results. The procedure should be considered in cases where complete surgical tumour resection is unlikely or carries a significant risk. If present, secondarily induced stenoses at the lateral ends of the transverse sinuses should also be considered for treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

References

  1. Durcan FJ, Corbett JJ, Wall M (1988) The incidence of pseudotumor cerebri. Population studies in Iowa and Louisiana. Arch Neurol 45(8):875–877

    Article  CAS  PubMed  Google Scholar 

  2. Radhakrishnan K, Ahlskog JE, Cross SA, Kurland LT, O’Fallon WM (1993) Idiopathic intracranial hypertension (pseudotumor cerebri). Descriptive epidemiology in Rochester, Minn, 1976 to 1990. Arch Neurol 50(1):78–80

    Article  CAS  PubMed  Google Scholar 

  3. Kesler A, Gadoth N (2001) Epidemiology of idiopathic intracranial hypertension in Israel. J Neuro-Ophthalmol Off J North Am NeuroOphthalmol Soc 21(1):12–14

    Article  CAS  Google Scholar 

  4. McCluskey G, Mulholland DA, McCarron P, McCarron MO (2015) Idiopathic intracranial hypertension in the northwest of Northern Ireland: epidemiology and clinical management. Neuroepidemiology 45(1):34–39

    Article  PubMed  Google Scholar 

  5. Entezami P, Gooch MR, Dalfino J (2019) Endovascular stenting of the superior sagittal sinus to alleviate venous compression caused by a parasagittal meningioma. BMJ Case Rep 12(4):e227935

    Article  PubMed  PubMed Central  Google Scholar 

  6. DiMeco F, Li KW, Casali C, Ciceri E, Giombini S, Filippini G et al (2008) Meningiomas invading the superior sagittal sinus: surgical experience in 108 cases. Neurosurgery 62(6 Suppl 3):1124–1135

    Article  PubMed  Google Scholar 

  7. Sindou MP, Alvernia JE (2006) Results of attempted radical tumor removal and venous repair in 100 consecutive meningiomas involving the major dural sinuses. J Neurosurg 105(4):514–525

    Article  PubMed  Google Scholar 

  8. Buster WP, Rodas RA, Fenstermaker RA, Kattner KA (2004) Major venous sinus resection in the surgical treatment of recurrent aggressive dural based tumors. Surg Neurol 62(6):522–529 discussion 529-530

    Article  PubMed  Google Scholar 

  9. Mathiesen T, Pettersson-Segerlind J, Kihlström L, Ulfarsson E (2014) Meningiomas engaging major venous sinuses. World Neurosurg 81(1):116–124

    Article  PubMed  Google Scholar 

  10. Han MS, Kim YJ, Moon KS, Lee KH, Yang JI, Kang WD et al (2016) Lessons from surgical outcome for intracranial meningioma involving major venous sinus. Medicine (Baltimore) 95(35):e4705

    Article  PubMed  Google Scholar 

  11. Raza SM, Gallia GL, Brem H, Weingart JD, Long DM, Olivi A (2010) Perioperative and long-term outcomes from the management of parasagittal meningiomas invading the superior sagittal sinus. Neurosurgery 67(4):885–893 discussion 893

    Article  PubMed  Google Scholar 

  12. Patsalides A, Oliveira C, Wilcox J, Brown K, Grover K, Gobin YP et al (2019) Venous sinus stenting lowers the intracranial pressure in patients with idiopathic intracranial hypertension. J Neurointerventional Surg 11(2):175–178

    Article  Google Scholar 

  13. Koovor JM, Lopez GV, Riley K, Tejada J (2018) Transverse venous sinus stenting for idiopathic intracranial hypertension: safety and feasibility. Neuroradiol J 31(5):513–517

    Article  PubMed  PubMed Central  Google Scholar 

  14. Higgins JNP, Owler BK, Cousins C, Pickard JD (2002) Venous sinus stenting for refractory benign intracranial hypertension. Lancet Lond Engl 359(9302):228–230

    Article  Google Scholar 

  15. Takahashi Y, Suda Y, Fushimi S, Shibata K, Kondo R, Oda M et al (2020) Endovascular stenting following stereotactic radiosurgery for meningioma involving the superior sagittal sinus. J Neuroendovascular Ther 14(7):273–278

    Article  Google Scholar 

  16. Chausson N, Bocquet J, Aveillan M, Olindo S, Signaté A, Merle H et al (2010) Intracranial hypertension caused by a meningioma compressing the transverse sinus. J Clin Neurosci Off J Neurosurg Soc Australas 17(12):1589–1592

    Google Scholar 

  17. Ganesan D, Higgins JNP, Harrower T, Burnet NG, Sarkies NJC, Manford M et al (2008) Stent placement for management of a small parasagittal meningioma. Technical note J Neurosurg 108(2):377–381

    PubMed  Google Scholar 

  18. Zilani G, Pereira EAC, Baig F, Uberoi R, Kuker W, Kerr RSC (2009) Venoplasty and stenting of a jugular foramen meningioma. Br J Neurosurg 23(5):557–560

    Article  CAS  PubMed  Google Scholar 

  19. Higgins JNP, Burnet NG, Schwindack CF, Waters A (2008) Severe brain edema caused by a meningioma obstructing cerebral venous outflow and treated with venous sinus stenting: Case report. J Neurosurg 108(2):372–376

    Article  PubMed  Google Scholar 

  20. Szitkar B (2010) A meningioma exclusively located inside the superior sagittal sinus responsible for intracranial hypertension. AJNR Am J Neuroradiol 31(6):E57–E58

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Higgins JNP, Kirollos SRW, Helmy A, Guilfoyle MR, Pickard JD, Axon PR, Joannides AJ, Jefferies S, Santarius T, Kirollos R (2023) Technical considerations and long-term results of endovascular venous stenting to control venous hypertension from meningiomas invading intracranial venous sinuses. J Neurosurg 1:1–13. https://doi.org/10.3171/2023.6.JNS23607

    Article  Google Scholar 

  22. Burgett RA, Purvin VA, Kawasaki A (1997) Lumboperitoneal shunting for pseudotumor cerebri. Neurology 49(3):734–739

    Article  CAS  PubMed  Google Scholar 

  23. Eggenberger ER, Miller NR, Vitale S (1996) Lumboperitoneal shunt for the treatment of pseudotumor cerebri. Neurology 46(6):1524–1530

    Article  CAS  PubMed  Google Scholar 

  24. Johnston I, Besser M, Morgan MK (1988) Cerebrospinal fluid diversion in the treatment of benign intracranial hypertension. J Neurosurg 69(2):195–202

    Article  CAS  PubMed  Google Scholar 

  25. Sunderland GJ, Jenkinson MD, Conroy EJ, Gamble C, Mallucci CL (2021) Neurosurgical CSF diversion in idiopathic intracranial hypertension: a narrative review. Life Basel Switz 11(5):393

    Google Scholar 

  26. Wang VY, Barbaro NM, Lawton MT, Pitts L, Kunwar S, Parsa AT et al (2007) Complications of lumboperitoneal shunts. Neurosurgery 60(6):1045–1048 discussion 1049

    Article  PubMed  Google Scholar 

  27. Rosenberg ML, Corbett JJ, Smith C, Goodwin J, Sergott R, Savino P et al (1993) Cerebrospinal fluid diversion procedures in pseudotumor cerebri. Neurology 43(6):1071–1072

    Article  CAS  PubMed  Google Scholar 

  28. Suri A, Pandey P, Mehta VS (2002) Subarachnoid hemorrhage and intracereebral hematoma following lumboperitoneal shunt for pseudotumor cerebri: a rare complication. Neurol India 50(4):508–510

    CAS  PubMed  Google Scholar 

  29. Banta JT, Farris BK (2000) Pseudotumor cerebri and optic nerve sheath decompression. Ophthalmology 107(10):1907–1912

    Article  CAS  PubMed  Google Scholar 

  30. Brazis PW (2008) Clinical review: the surgical treatment of idiopathic pseudotumour cerebri (idiopathic intracranial hypertension). Cephalalgia Int J Headache 28(12):1361–1373

    Article  CAS  Google Scholar 

  31. Plotnik JL, Kosmorsky GS (1993) Operative complications of optic nerve sheath decompression. Ophthalmology 100(5):683–690

    Article  CAS  PubMed  Google Scholar 

  32. Mariniello G, Giamundo A, Donzelli R, Severino R, Russo C, Elefante A et al (2013) Intracranial hypertension due to meningioma of the unique transverse sinus. Neuroradiol J 26(2):209–212

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Hunt MG, Lee AG, Kardon RH, Lesley WS, Chaloupka JC (2001) Improvement in papilledema and visual loss after endovascular stent placement in dural sinus thrombosis. Neuro-Ophthalmol Aeolus Press 26(2):85–92

    Article  CAS  Google Scholar 

  34. Teleb MS, Cziep ME, Lazzaro MA, Gheith A, Asif K, Remler B et al (2013) Idiopathic intracranial hypertension. A systematic analysis of transverse sinus stenting. Interv Neurol 2(3):132–143

    Article  PubMed  Google Scholar 

Download references

Funding

No funding was required.

Author information

Authors and Affiliations

  1. Department of Imaging, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK

    Gasim Ahmed, Mahmoud Abou-foul & Norman McConachie

  2. Department of Neurosurgery, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK

    William Sage

Authors
  1. Gasim Ahmed
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mahmoud Abou-foul
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. William Sage
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Norman McConachie
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gasim Ahmed.

Ethics declarations

Conflict of interest

Nothing to disclose.

Ethics approval

Departmental ethical approval was not required for this work.

Informed consent

Obtained.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ahmed, G., Abou-foul, M., Sage, W. et al. Endovascular stenting for cerebral venous sinus stenosis secondary to meningioma invasion. Neuroradiology 66, 817–824 (2024). https://doi.org/10.1007/s00234-024-03321-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-024-03321-2

Keywords

Search

Navigation