Correlation between lumbar puncture opening pressure and venous sinus pressure gradient in idiopathic intracranial hypertension (IIH)
Year: 2025
Type: article
Abstract: Background Venous hypertension has become a recognized condition associated with idiopathic intracranial hypertension (IIH). Thresholds for dural venous sinus stenting (VSS) remain a topic of debate. Methods In 50 IIH patients, the lumbar puncture opening pressure (LPOP) and the pressure gradient across the dominant venous sinus were correlated. Clinical variables were compared; linear regression models were created. Venous stenting was performed in select patients with bilateral venous sinus stenosis, papilledema, LPOP >25 cmH2O, and a venous pressure gradient >10 mmHg. Results Twenty-nine patients were selected for venous sinus stenting (VSS); 21 patients did not meet the criteria for stenting despite some IIH symptoms. After stent implantation, patients experienced improvement in their symptoms. Across all 50 patients, there was a significant correlation between LPOP and the pressure gradient across the stenosis of the dominant venous sinus ( r = 0.76, 95% confidence interval [0.53–1.00], P < .001). Conclusions An increased venous pressure gradient across the dominant sigmoid/transverse junction was strongly associated with an increased lumbar puncture opening pressure in IIH patients. A gradient increase of 1 mmHg correlated with an increase of LPOP by 0.85 cmH2O. Patients with higher baseline venous pressure gradients may therefore benefit the most from venous stenting.
Source: Interventional Neuroradiology
Institutions: Duke University Hospital, Duke University
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4409824117