Reversal of Cerebral Sinus Venous Stenosis in a Patient With Idiopathic Intracranial Hypertension

The mechanism of increased intracranial pressure (ICP) in idiopathic intracranial hypertension (IIH) remains unknown. In 30%-93% of patients, a unilateral or bilateral transverse sinus or transverse-sigmoid junction stenosis is present1. There is an ongoing debate whether venous sinus stenosis is the cause of IIH or a result thereof. One of the leading theories is of a 'vicious cycle' where an increased ICP causes cerebral venous sinuses stenosis (CVSS) and that in turn, decreases venous drainage and increases ICP. Previous studies have demonstrated reduction of transverse sinus stenosis after cerebrospinal fluid (CSF) diversion or immediately post lumbar puncture2-5. Here we present a patient who had reversal of transverse- sigmoid sinus junction stenosis after decresing ICP using a continuous lumbar CSF drainage.