Concurrent venous stenting of the transverse and occipito-marginal sinuses: An analogy with parallel hemodynamic circuits

Thomas Buell, Daniel S. Raper, Dale Ding, Ching Jen Chen, Tony Wang, Davis Taylor, Adeel Ilyas, Mohammad S. Kalani, Min Park, Kelly Mahaney, Kenneth Liu

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Nonthrombotic intracranial venous occlusive disease (NIVOD) has been implicated in the pathophysiology of idiopathic intracranial hypertension (IIH) and various non-IIH headache syndromes. Endovascular stenting of stenotic, dominant transverse sinuses (TSs) may reduce trans-stenosis pressure gradients, decrease intracranial pressure, and alleviate symptoms in a subset of NIVOD patients. We present a case in which concurrent stenting of the occipito-marginal sinus obliterated the residual trans-stenosis pressure gradient across an initially stented dominant TS. We hypothesize that this observation may be explained using an electric-hydraulic analogy, and that this patient's dominant TS and occipito-marginal sinus may be modeled as a parallel hemodynamic circuit. Neurointerventionalists should be aware of parallel hemodynamic drainage patterns and consider manometry and possibly additional stenting of stenotic, parallel venous outflow pathways if TS stenting alone fails to obliterate the trans-stenosis pressure gradient.

Original languageEnglish (US)
Pages (from-to)334-338
Number of pages5
JournalJournal of Neurosciences in Rural Practice
Volume10
Issue number2
DOIs
StatePublished - Apr 1 2019

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)
  • Clinical Neurology

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