Mayo Clinic neuroradiologist, Waleed Brinjikji, M.D., discusses idiopathic intracranial hypertension (IIH) treatment. All patients see a collaborative care team. Dr. Brinjikji discusses venous sinus stenting, which is an outpatient procedure performed under sedation.
idiopathic intracranial hypertension or I Ih is elevation in the pressure of the brain that has no clear cause about it. That's what idiopathic means. It means we don't know what's causing it. All of the patients end up seeing one of our neurologists and one of our neural ophthalmologist. And in the majority of cases the symptoms are very mild and they can be managed with just medication. Now, if the patients are not able to tolerate the medication or despite having, you know, the medication, their symptoms are worsening, then they get referred to our team for venus sinus, stenting that procedure of taking the catheter across the narrowing and then placing a stent to prop that narrowing open our team. Our ophthalmologists are neurologists and our surgeons feel that this is the safest and most minimally invasive option for treating these patients. What we would typically do is we have a consultation where I would talk to the patient and then they would come in for the procedure which is an outpatient procedure, but it's performed under very heavy sedation. So the patients very Comfortable. So the procedure in and of itself is a very safe procedure. It takes about 20-30 minutes to perform. I would say 95% of our patients go home the day of the procedure. Sometimes it can be a little bit of discomfort on the side where we where we put the stent patients kind of feel back to themselves after a few days. In 80% of patients when we put the stent in, it works great. And about 20% of patients, they may have kind of a fluctuating course where sometimes their symptoms are getting better, sometimes they're not. And some of those patients, what we see is that they get more swelling of the brain and we have to place another stent or open the first stent a little bit more. The only permanent solution that we know of to date has been weight loss for idiopathic intracranial hypertension. We have the largest experience in the country regarding the use of venous sinus stenting. So this is something that, you know, we've been able to do very well very safely, uh, and very efficiently.