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Brain stent offers alternative to shunt for fixing potentially blinding vein narrowing
Date:3/13/2013

A team of interventional neuroradiologists and neurosurgeons at Johns Hopkins reports wide success with a new procedure to treat pseudotumor cerebri, a rare but potentially blinding condition marked by excessive pressure inside the skull, caused by a dangerous narrowing of a vein located at the base of the brain.

The Johns Hopkins team's latest study, to be published in the Journal of Neuro-Ophthalmology online March 14, is believed to be the first to show how directly lowering pressure inside the vein alleviates the condition and improves vision.

The study report on 12 patients describes the team's novel use of intravascular ultrasound imaging to delicately thread an expandable metal stent, roughly two inches long and attached to a catheter, through an opening in the groin, all the way to the main blood vessels in the neck and shoulders draining fluid from the brain. The goal is to precisely position the stent across the narrowed portion of the vein, called the transverse sinus, where it expands, allowing blood to drain more freely and relieving fluid pressure in the brain. The vein narrowing, or stenosis, is considered to be the leading cause of pseudotumor cerebri. The condition earned its name, which translates to "false" tumor of the brain, because in the era before detailed brain imaging became available, surgeons used to operate on people with similar optic nerve swelling, suspecting brain tumors, yet they would find none.

Because the transverse sinus drains cerebrospinal fluid, constriction of the vessel causes fluid backup and raises intracranial pressure, which, if left untreated, can lead to permanent damage to the optic nerve, blurred vision and eventual blindness. Traditional treatments include drugs that reduce pressure and the surgical placement of a straw-like shunt between the lower spine and brain, or between the lower spine and stomach cavity to drain excess.

According to lead study investigator a
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Contact: David March
dmarch1@jhmi.edu
410-955-1534
Johns Hopkins Medicine
Source:Eurekalert

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