Endovascular stenting for intracranial venous hypertension caused by meningioma: A case series and systematic literature review

Abstract

Background & purpose

Venous intracranial hypertension is defined as an increased intracranial pressure secondary to venous congestion. Specific causes of venous hypertension can be identified, including extrinsic venous sinus compression or invasion by intracranial tumors such as meningioma. We aimed to report a case series of four patients with symptomatic venous intracranial hypertension secondary to meningioma and treated with stenting. We also performed a systematic literature review.

Methods

The local case series included consecutive patients with symptomatic venous intracranial hypertension who underwent venous sinus stenting in our center between January 2010 and June 2024. Initial clinical presentation, imaging data, treatment details and long-term outcomes were presented. A systematic literature review was performed according to PRISMA guidelines up to June 2024.

Results

Four patients were treated in our center during the study period. In all cases, stenting was adequately performed without complication. Patients experienced substantial and durable clinical improvement, including papilledema resorption. Eight publications were included in the literature review (28 patients). Including our 4 reported cases, a total of 32 patients were analyzed in the systematic review. Complete symptoms recovery occurred in 25 patients (78.1 %) and a partial resolution in 7 (21.9 %). Twelve patients received adjuvant radiotherapy, two of whom also underwent surgery. Five patients presented clinical recurrence and required endovascular retreatment. No complications were reported.

Conclusion

In the setting of a compression or invasion due to a meningioma, stenting of symptomatic intracranial venous stenoses appeared as a safe and promisingly effective option.