Combined surgical repair and venous sinus stenting for patients with skull base encephaloceles secondary to dural venous sinus stenosis.
CSF leak
Encephalocele
Sinus stenting
Skull base defect
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
received:
04
03
2023
accepted:
09
06
2023
medline:
9
8
2023
pubmed:
22
6
2023
entrez:
21
6
2023
Statut:
ppublish
Résumé
Chronically elevated intracranial pressure (ICP) seen in idiopathic intracranial hypertension (IIH) can cause the development of skull base encephaloceles and cerebrospinal fluid (CSF) leaks. Surgical repair and ventriculoperitoneal shunt (VPS) placement are mainstays of treatment. Venous sinus stenting (VSS) is a newly accepted treatment modality. The goal of this study was thus to determine if VSS can be used to treat symptoms and prevent recurrence after surgical encephalocele repair. Retrospective chart review of patients that had surgical repair of encephaloceles followed by VSS for symptomatic stenosis with elevated pressure gradient. A total of 13 patients underwent a combined encephalocele repair and VSS. Seventy-two percent were female; 46% had headaches, 69% pulsatile tinnitus, and 92% CSF rhinorrhea or otorrhea. One had seizures. Mean lumbar opening pressure was 23.3 ± 2.6 cm H In patients with dural sinus stenosis and encephaloceles requiring repair, VSS can be performed safely within weeks of surgery for relief of symptoms, resolution of underlying pathology, and prevention of CSF leak recurrence.
Sections du résumé
BACKGROUND
Chronically elevated intracranial pressure (ICP) seen in idiopathic intracranial hypertension (IIH) can cause the development of skull base encephaloceles and cerebrospinal fluid (CSF) leaks. Surgical repair and ventriculoperitoneal shunt (VPS) placement are mainstays of treatment. Venous sinus stenting (VSS) is a newly accepted treatment modality. The goal of this study was thus to determine if VSS can be used to treat symptoms and prevent recurrence after surgical encephalocele repair.
METHODS
Retrospective chart review of patients that had surgical repair of encephaloceles followed by VSS for symptomatic stenosis with elevated pressure gradient.
RESULTS
A total of 13 patients underwent a combined encephalocele repair and VSS. Seventy-two percent were female; 46% had headaches, 69% pulsatile tinnitus, and 92% CSF rhinorrhea or otorrhea. One had seizures. Mean lumbar opening pressure was 23.3 ± 2.6 cm H
CONCLUSION
In patients with dural sinus stenosis and encephaloceles requiring repair, VSS can be performed safely within weeks of surgery for relief of symptoms, resolution of underlying pathology, and prevention of CSF leak recurrence.
Identifiants
pubmed: 37344735
doi: 10.1007/s00701-023-05680-w
pii: 10.1007/s00701-023-05680-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2283-2292Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.
Références
Akhter A, Schulz L, Inger HE, McGregor JM (2022) Current indications for management options in pseudotumor cerebri. Neurol Clin 40:391–404. https://doi.org/10.1016/j.ncl.2021.11.011
doi: 10.1016/j.ncl.2021.11.011
pubmed: 35465882
Algattas HN, Wang EW, Zenonos GA, Snyderman CH, Gardner PA (2021) Endoscopic endonasal surgery for anterior cranial fossa meningiomas. J Neurosurg Sci 65:118–132. https://doi.org/10.23736/s0390-5616.20.05085-7
Arnaout MM, Hanz SZ, Heier LA, Schwartz TH (2021) Prevalence and outcome of anterior and middle cranial fossae encephaloceles without cerebrospinal fluid leak or meningitis. World Neurosurg 149:e828–e835. https://doi.org/10.1016/j.wneu.2021.01.088
doi: 10.1016/j.wneu.2021.01.088
pubmed: 33529766
Barrero Ruiz E, Iglesias Moroño S, Ros López B, Morales Martinez A, Díaz T, Arráez Sánchez M (2022) Life-threatening idiopathic intracranial hypertension: the role of venous sinus stenting. Childs Nerv Syst. https://doi.org/10.1007/s00381-022-05564-x
doi: 10.1007/s00381-022-05564-x
pubmed: 35687167
Bidot S, Levy JM, Saindane AM, Narayana KM, Dattilo M, DelGaudio JM, Mattox DE, Oyesiku NM, Peragallo JH, Solares CA, Vivas EX, Wise SK, Newman NJ, Biousse V (2021) Spontaneous skull base cerebrospinal fluid leaks and their relationship to idiopathic intracranial hypertension. Am J Rhinol Allergy 35:36–43. https://doi.org/10.1177/1945892420932490
doi: 10.1177/1945892420932490
pubmed: 32551921
Bidot S, Levy JM, Saindane AM, Oyesiku NM, Newman NJ, Biousse V (2019) Do most patients with a spontaneous cerebrospinal fluid leak have idiopathic intracranial hypertension? J Neuroophthalmol 39:487–495. https://doi.org/10.1097/wno.0000000000000761
doi: 10.1097/wno.0000000000000761
pubmed: 30747786
pmcid: 6687566
Camras LR, Ecanow JS, Abood CA (1998) Spontaneous cerebrospinal fluid rhinorrhea in a patient with pseudotumor cerebri. J Neuroimaging 8:41–42. https://doi.org/10.1111/jon19988141
doi: 10.1111/jon19988141
pubmed: 9442590
Carrau RL, Snyderman CH, Kassam AB (2005) The management of cerebrospinal fluid leaks in patients at risk for high-pressure hydrocephalus. Laryngoscope 115:205–212. https://doi.org/10.1097/01.mlg.0000154719.62668.70
doi: 10.1097/01.mlg.0000154719.62668.70
pubmed: 15689736
Dinkin MJ, Patsalides A (2017) Venous sinus stenting for idiopathic intracranial hypertension: where are we now? Neurol Clin 35:59–81. https://doi.org/10.1016/j.ncl.2016.08.006
doi: 10.1016/j.ncl.2016.08.006
pubmed: 27886896
Fargen KM (2022) Venous stenting for idiopathic intracranial hypertension: lessons learned from a high-volume practice. J Neurointerv Surg 14:528–532. https://doi.org/10.1136/neurintsurg-2021-018184
doi: 10.1136/neurintsurg-2021-018184
pubmed: 34551993
Fargen KM, Liu K, Garner RM, Greeneway GP, Wolfe SQ, Crowley RW (2018) Recommendations for the selection and treatment of patients with idiopathic intracranial hypertension for venous sinus stenting. J Neurointerv Surg 10:1203–1208. https://doi.org/10.1136/neurintsurg-2018-014042
doi: 10.1136/neurintsurg-2018-014042
pubmed: 30030306
Ha CM, Hong SD, Choi JW, Seol HJ, Nam DH, Lee JI, Kong DS (2021) Graded reconstruction strategy using a multilayer technique without lumbar drainage after endoscopic endonasal surgery. World Neurosurg. https://doi.org/10.1016/j.wneu.2021.11.003
doi: 10.1016/j.wneu.2021.11.003
pubmed: 34767991
Hanz SZ, Lt A, Schmidt F, Kacker A, Tsiouris AJ, Anand VK, Schwartz TH (2020) Low incidence of true Sternberg’s canal defects among lateral sphenoid sinus encephaloceles. Acta Neurochir (Wien) 162:2413–2420. https://doi.org/10.1007/s00701-020-04329-2
doi: 10.1007/s00701-020-04329-2
pubmed: 32372133
Hegazy HM, Carrau RL, Snyderman CH, Kassam A, Zweig J (2000) Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea: a meta-analysis. Laryngoscope 110:1166–1172. https://doi.org/10.1097/00005537-200007000-00019
doi: 10.1097/00005537-200007000-00019
pubmed: 10892690
Hong CS, Kundishora AJ, Elsamadicy AA, Vining EM, Manes RP, Omay SB (2022) A unique subset: idiopathic intracranial hypertension presenting as spontaneous CSF leak of the anterior skull base. J Neurol Surg B Skull Base 83:105–115. https://doi.org/10.1055/s-0040-1716898
doi: 10.1055/s-0040-1716898
pubmed: 35433188
Hubbard JL, McDonald TJ, Pearson BW, Laws ER Jr (1985) Spontaneous cerebrospinal fluid rhinorrhea: evolving concepts in diagnosis and surgical management based on the Mayo Clinic experience from 1970 through 1981. Neurosurgery 16:314–321. https://doi.org/10.1227/00006123-198503000-00006
doi: 10.1227/00006123-198503000-00006
pubmed: 3982609
Kalyvas A, Neromyliotis E, Koutsarnakis C, Komaitis S, Drosos E, Skandalakis GP, Pantazi M, Gobin YP, Stranjalis G, Patsalides A (2021) A systematic review of surgical treatments of idiopathic intracranial hypertension (IIH). Neurosurg Rev 44:773–792. https://doi.org/10.1007/s10143-020-01288-1
doi: 10.1007/s10143-020-01288-1
pubmed: 32335853
Lal D, Cain RB (2014) Updates in reconstruction of skull base defects. Curr Opin Otolaryngol Head Neck Surg 22:419–428. https://doi.org/10.1097/moo.0000000000000082
doi: 10.1097/moo.0000000000000082
pubmed: 25101935
Lee JA, Byun YJ, Nguyen SA, Schlosser RJ, Gudis DA (2020) Endonasal endoscopic surgery for pediatric anterior cranial fossa encephaloceles: a systematic review. Int J Pediatr Otorhinolaryngol 132:109919. https://doi.org/10.1016/j.ijporl.2020.109919
doi: 10.1016/j.ijporl.2020.109919
pubmed: 32036168
Lenck S, Nouet A, Shotar E, Abi Jaoudé S, Nicholson P, Premat K, Corcy C, Boch AL, Sourour NA, Tankere F, Carpentier A, Clarençon F (2021) Transverse sinus stenting without surgical repair in idiopathic CSF rhinorrhea associated with transverse sinus stenoses: a pilot study. J Neurosurg 136(6):1745–1751. https://doi.org/10.3171/2021.5.Jns21894
Manjubashini D, Kiran M, Akshaya S, Nagarajan K (2019) Intrasphenoidal encephalocele with spontaneous cerebrospinal fluid rhinorrhea in idiopathic intracranial hypertension: need for clarity in terminology and imaging delineation. World Neurosurg 132:129–133. https://doi.org/10.1016/j.wneu.2019.08.186
doi: 10.1016/j.wneu.2019.08.186
pubmed: 31491574
Martin TJ, Loehrl TA (2007) Endoscopic CSF leak repair. Curr Opin Otolaryngol Head Neck Surg 15:35–39. https://doi.org/10.1097/MOO.0b013e3280123fce
doi: 10.1097/MOO.0b013e3280123fce
pubmed: 17211181
Mattox DE, Kennedy DW (1990) Endoscopic management of cerebrospinal fluid leaks and cephaloceles. Laryngoscope 100:857–862. https://doi.org/10.1288/00005537-199008000-00012
doi: 10.1288/00005537-199008000-00012
pubmed: 2381261
Mirza S, Thaper A, McClelland L, Jones NS (2005) Sinonasal cerebrospinal fluid leaks: management of 97 patients over 10 years. Laryngoscope 115:1774–1777. https://doi.org/10.1097/01.mlg.0000175679.68452.75
doi: 10.1097/01.mlg.0000175679.68452.75
pubmed: 16222193
Owler BK, Allan R, Parker G, Besser M (2003) Pseudotumour cerebri, CSF rhinorrhoea and the role of venous sinus stenting in treatment. Br J Neurosurg 17:79–83. https://doi.org/10.3109/02688690309177979
doi: 10.3109/02688690309177979
pubmed: 12779209
Pan DW, Vanstrum E, Doherty JK (2022) Idiopathic intracranial hypertension: implications for the otolaryngologist. Otolaryngol Clin North Am 55:579–594. https://doi.org/10.1016/j.otc.2022.02.005
doi: 10.1016/j.otc.2022.02.005
pubmed: 35490040
Peng D, Yang K, Wu C, Gao F, Sun W, Lu G (2022) Ventriculoperitoneal shunt alone for cerebrospinal fluid rhinorrhea with neuroendocrine alterations in idiopathic intracranial hypertension: a case report and literature review. Front Neurol 13:809224. https://doi.org/10.3389/fneur.2022.809224
doi: 10.3389/fneur.2022.809224
pubmed: 35222246
pmcid: 8866819
Pérez MA, Bialer OY, Bruce BB, Newman NJ, Biousse V (2013) Primary spontaneous cerebrospinal fluid leaks and idiopathic intracranial hypertension. J Neuroophthalmol 33:330–337. https://doi.org/10.1097/WNO.0b013e318299c292
doi: 10.1097/WNO.0b013e318299c292
pubmed: 24042170
pmcid: 4040082
Reddy M, Baugnon K (2017) Imaging of cerebrospinal fluid rhinorrhea and otorrhea. Radiol Clin North Am 55:167–187. https://doi.org/10.1016/j.rcl.2016.08.005
doi: 10.1016/j.rcl.2016.08.005
pubmed: 27890184
Schlosser RJ, Wilensky EM, Grady MS, Palmer JN, Kennedy DW, Bolger WE (2004) Cerebrospinal fluid pressure monitoring after repair of cerebrospinal fluid leaks. Otolaryngol Head Neck Surg 130:443–448. https://doi.org/10.1016/j.otohns.2003.12.018
doi: 10.1016/j.otohns.2003.12.018
pubmed: 15100641
Schlosser RJ, Woodworth BA, Wilensky EM, Grady MS, Bolger WE (2006) Spontaneous cerebrospinal fluid leaks: a variant of benign intracranial hypertension. Ann Otol Rhinol Laryngol 115:495–500. https://doi.org/10.1177/000348940611500703
doi: 10.1177/000348940611500703
pubmed: 16900803
Schwarz J, Al Balushi A, Sundararajan S, Dinkin M, Oliveira C, Greenfield JP, Patsalides A (2021) Management of idiopathic intracranial hypertension in children utilizing venous sinus stenting. Interv Neuroradiol 27:257–265. https://doi.org/10.1177/1591019920976234
doi: 10.1177/1591019920976234
pubmed: 33236688
Sinclair AJ, Kuruvath S, Sen D, Nightingale PG, Burdon MA, Flint G (2011) Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review. Cephalalgia 31:1627–1633. https://doi.org/10.1177/0333102411423305
doi: 10.1177/0333102411423305
pubmed: 21968519
Smith JL (1985) Whence pseudotumor cerebri? J Clin Neuroophthalmol 5:55–56
pubmed: 3156890
Spacca B, Amasio ME, Giordano F, Mussa F, Busca G, Donati P, Genitori L (2009) Surgical management of congenital median perisellar transsphenoidal encephaloceles with an extracranial approach: a series of 6 cases. Neurosurgery 65:1140–1145; discussion 1145–1146. https://doi.org/10.1227/01.Neu.0000351780.23357.F5
Tam EK, Gilbert AL (2019) Spontaneous cerebrospinal fluid leak and idiopathic intracranial hypertension. Curr Opin Ophthalmol 30:467–471. https://doi.org/10.1097/icu.0000000000000603
doi: 10.1097/icu.0000000000000603
pubmed: 31449087
Teachey W, Grayson J, Cho DY, Riley KO, Woodworth BA (2017) Intervention for elevated intracranial pressure improves success rate after repair of spontaneous cerebrospinal fluid leaks. Laryngoscope 127:2011–2016. https://doi.org/10.1002/lary.26612
doi: 10.1002/lary.26612
pubmed: 28512741
Thanki S, Guerrero W, Mokin M (2022) Treatment of pseudotumor cerebri (sinus stenosis). Neurosurg Clin N Am 33:207–214. https://doi.org/10.1016/j.nec.2021.11.002
doi: 10.1016/j.nec.2021.11.002
pubmed: 35346452
Tuță S (2022) Cerebral venous outflow implications in idiopathic intracranial hypertension-from physiopathology to treatment. Life (Basel) 12(6):854. https://doi.org/10.3390/life12060854
Wang EW, Vandergrift WA 3rd, Schlosser RJ (2011) Spontaneous CSF leaks. Otolaryngol Clin North Am 44(845–856):vii. https://doi.org/10.1016/j.otc.2011.06.018
doi: 10.1016/j.otc.2011.06.018
pubmed: 21819875
Wang S, Tong X, Li X, Liu L, Liu Z, Mo D, Wang Y (2022) Association of post-intervention pressure gradient with symptom-free at 6 months in idiopathic intracranial hypertension with venous sinus stenosis treated by stenting. Interv Neuroradiol 15910199221095044. https://doi.org/10.1177/15910199221095044
Wang S, Tong X, Li X, Liu L, Liu Z, Mo D, Wang Y (2022) Comparison of microcatheter and pressure wire for venous sinus manometric evaluation of patients with idiopathic intracranial hypertension. Interv Neuroradiol 15910199221096679. https://doi.org/10.1177/15910199221096679
Woodworth BA, Prince A, Chiu AG, Cohen NA, Schlosser RJ, Bolger WE, Kennedy DW, Palmer JN (2008) Spontaneous CSF leaks: a paradigm for definitive repair and management of intracranial hypertension. Otolaryngol Head Neck Surg 138:715–720. https://doi.org/10.1016/j.otohns.2008.02.010
doi: 10.1016/j.otohns.2008.02.010
pubmed: 18503841
Youngerman BE, Kosty JA, Gerges MM, Tabaee A, Kacker A, Anand VK, Schwartz TH (2020) Acellular dermal matrix as an alternative to autologous fascia lata for skull base repair following extended endoscopic endonasal approaches. Acta Neurochir (Wien) 162:863–873. https://doi.org/10.1007/s00701-019-04200-z
doi: 10.1007/s00701-019-04200-z
pubmed: 32048039
Zhao K, Gu W, Liu C, Kong D, Zheng C, Chen W, Li X, Liang Y, Zhou H (2022) Advances in the understanding of the complex role of venous sinus stenosis in idiopathic intracranial hypertension. J Magn Reson Imaging. https://doi.org/10.1002/jmri.28177
doi: 10.1002/jmri.28177
pubmed: 36583731
pmcid: 9790544