I read with great interest the paper entitled “Reversibility of Venous Sinus Obstruction in Idiopathic Intracranial Hypertension” recently published in the American Journal of Neuroradiology by Rohr et al. This paper presents the case histories of 3 patients with idiopathic intracranial hypertension (IIH) and venous outflow stenoses. I believe that the assertion by Rohr et al that placement of a stent should not be offered to patients who have IIH and collapsible stenoses is not necessarily correct. The only proviso is that the stent must support all of the compliant sections of the venous system or the stenosis will recur. Ultimately, whether the front-line treatment of IIH associated with collapsible venous outflow is stent placement orshunt insertion will depend on the relative morbidity of these procedures and their long-term rates of success.
American Journal of Neuroradiology Vol. 29, Issue 2