{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:25:10Z","timestamp":1770114310966,"version":"3.49.0"},"reference-count":64,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"10","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,3,10]]},"abstract":"\n BACKGROUND<\/jats:title>\n Venous sinus injury resulting in thrombosis is a possible complication of skull base surgery and neck dissection. Although usually asymptomatic, sinus thrombosis can obstruct the dominant cranial venous outflow pathways, leading to a cycle of increased intracranial pressure secondary to venous congestion, which further compresses the remaining sinuses in a positive feedback loop. This can present with symptoms resembling idiopathic intracranial hypertension.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A patient underwent a left mastoidectomy for chronic mastoiditis, complicated by injury of the ipsilateral dominant sigmoid sinus, with subsequent thrombosis. The patient developed chronic severe headaches, papilledema, visual blurring, and tinnitus. Angiography revealed a contralateral arachnoid granulation causing stenosis of the remaining venous outflow tract with a pressure gradient of 18 mm Hg. Transverse sinus stenting led to normalization of the gradient and resolution of symptoms.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Injury of a dominant cranial venous outflow pathway led to a feedback loop that caused increased intracranial pressures and worsening contralateral transverse sinus stenosis, which was successfully treated using transverse sinus stenting. Venous congestive physiology leading to intracranial hypertension is underrecognized as a complication of venous injury in skull base surgery and responds to stenting if the patient\u2019s symptoms are refractory to conservative management or anticoagulation.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24781<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24781","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T02:59:56Z","timestamp":1741575596000},"source":"Crossref","is-referenced-by-count":0,"title":["Iatrogenic intracranial venous hypertension treated with intracranial venous stenting: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"M. Harrison","family":"Snyder","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl B.","family":"Heilman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adel M.","family":"Malek","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"Am J Otol","first-page":"701","article-title":"Complications of venous insufficiency after neurotologic-skull base surgery","volume":"21","author":"Roberson","year":"2000","unstructured":"Roberson JBBrackmann DEFayad JN.Complications of venous insufficiency after neurotologic-skull base surgery. Am J Otol. 2000;21(5):701-705."},{"issue":"2","key":"bib2","series-title":"J Neurosurg","first-page":"192","article-title":"Dural sinus thrombosis and pseudotumor cerebri: unexpected complications of suboccipital craniotomy and translabyrinthine craniectomy","volume":"91","author":"Keiper","year":"1999","unstructured":"Keiper GLSherman JDTomsick TATew JM.Dural sinus thrombosis and pseudotumor cerebri: unexpected complications of suboccipital craniotomy and translabyrinthine craniectomy. J Neurosurg. 1999;91(2):192-197."},{"issue":"7","key":"bib3","series-title":"J NeuroIntervent Surg","first-page":"587","article-title":"A unifying theory explaining venous sinus stenosis and recurrent stenosis following venous sinus stenting in patients with idiopathic intracranial hypertension","volume":"13","author":"Fargen","year":"2021","unstructured":"Fargen KM.A unifying theory explaining venous sinus stenosis and recurrent stenosis following venous sinus stenting in patients with idiopathic intracranial hypertension. J NeuroIntervent Surg. 2021;13(7):587-592."},{"issue":"6","key":"bib4","series-title":"J Neuroradiol","first-page":"581","article-title":"Cerebral venous disorders: diagnosis and endovascular management","volume":"50","author":"Abdalkader","year":"2023","unstructured":"Abdalkader MHui FAmans MRCerebral venous disorders: diagnosis and endovascular management. J Neuroradiol. 2023;50(6):581-592."},{"issue":"4","key":"bib5","series-title":"Interv Neuroradiol","first-page":"524","article-title":"Technical and clinical success after venous sinus stenting for treatment of idiopathic intracranial hypertension using a novel guide catheter for access: case series and initial multi-center experience","volume":"30","author":"Zyck","year":"2024","unstructured":"Zyck SMalik MWebb MTechnical and clinical success after venous sinus stenting for treatment of idiopathic intracranial hypertension using a novel guide catheter for access: case series and initial multi-center experience. Interv Neuroradiol. 2024;30(4):524-528."},{"issue":"1","key":"bib6","series-title":"J Vasc Interv Neurol","first-page":"6","article-title":"Safety and clinical outcomes after transverse venous sinus stenting for treatment of refractory idiopathic intracranial hypertension: single center experience","volume":"11","author":"Kulhari","year":"2020","unstructured":"Kulhari AHe MFourcand FSafety and clinical outcomes after transverse venous sinus stenting for treatment of refractory idiopathic intracranial hypertension: single center experience. J Vasc Interv Neurol. 2020;11(1):6-12."},{"issue":"6","key":"bib7","series-title":"Interv Neurol","first-page":"490","article-title":"Stent survival and stent-adjacent stenosis rates following venous sinus stenting for idiopathic intracranial hypertension: a systematic review and meta-analysis","volume":"7","author":"Saber","year":"2018","unstructured":"Saber HLewis WSadeghi MRajah GNarayanan S. Stent survival and stent-adjacent stenosis rates following venous sinus stenting for idiopathic intracranial hypertension: a systematic review and meta-analysis. Interv Neurol. 2018;7(6):490-500."},{"issue":"9","key":"bib8","series-title":"J Neurointerv Surg","first-page":"867","article-title":"Dural sinus stenting for idiopathic intracranial hypertension: factors associated with hemodynamic failure and management with extended stenting","volume":"9","author":"Kumpe","year":"2017","unstructured":"Kumpe DASeinfeld JHuang XDural sinus stenting for idiopathic intracranial hypertension: factors associated with hemodynamic failure and management with extended stenting. 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AJNR Am J Neuroradiol. 2011;32(8):1408-1414."},{"key":"bib11","series-title":"Sci World J","first-page":"1","article-title":"Endovascular treatment of venous sinus stenosis in idiopathic intracranial hypertension: complications, neurological outcomes, and radiographic results","volume":"2015","author":"Starke","year":"2015","unstructured":"Starke RMWang TDing DEndovascular treatment of venous sinus stenosis in idiopathic intracranial hypertension: complications, neurological outcomes, and radiographic results. Sci World J. 2015;2015:1-8."},{"issue":"6","key":"bib12","series-title":"J Plast Reconstr Aesthet Surg","first-page":"1239","article-title":"Internal jugular vein thrombosis and pulmonary thromboembolism after head and neck reconstructive surgery","volume":"74","author":"Kitano","year":"2021","unstructured":"Kitano DYonezawa KIwae SSakakibara S.Internal jugular vein thrombosis and pulmonary thromboembolism after head and neck reconstructive surgery. 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J Neurol Surg B Skull Base. 2021;82(suppl 3):e3-e8."},{"issue":"4","key":"bib21","series-title":"J Neurosurg","first-page":"575","article-title":"Occlusion of the sigmoid sinus after surgery via the presigmoidal-transpetrosal approach","volume":"89","author":"Ohata","year":"1998","unstructured":"Ohata KHaque MMorino MOcclusion of the sigmoid sinus after surgery via the presigmoidal-transpetrosal approach. J Neurosurg. 1998;89(4):575-584."},{"issue":"6","key":"bib22","series-title":"Oper Neurosurg (Hagerstown)","first-page":"721","article-title":"Management of sigmoid sinus injury: retrospective study of 450 consecutive surgeries in the cerebellopontine angle and intrapetrous region","volume":"19","author":"Matsushima","year":"2020","unstructured":"Matsushima KKohno MTanaka YNakajima NIchimasu N.Management of sigmoid sinus injury: retrospective study of 450 consecutive surgeries in the cerebellopontine angle and intrapetrous region. 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J Neurosurg. 2014;121(2):441-449."},{"issue":"6","key":"bib28","series-title":"Interv Neuroradiol","first-page":"718","article-title":"Unexpected occlusion of the contralateral transverse sinus after stenting for idiopathic intracranial hypertension","volume":"24","author":"Coffman","year":"2018","unstructured":"Coffman SASingh JWolfe SFargen KM.Unexpected occlusion of the contralateral transverse sinus after stenting for idiopathic intracranial hypertension. Interv Neuroradiol. 2018;24(6):718-721."},{"issue":"3","key":"bib29","series-title":"Interv Neuroradiol","first-page":"336","article-title":"Utility of the novel guide catheter in mechanical thrombectomy for emergent large vessel occlusion stroke","volume":"30","author":"Zakeri","year":"2024","unstructured":"Zakeri ASchreiber CShah VUtility of the novel guide catheter in mechanical thrombectomy for emergent large vessel occlusion stroke. 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Am J Otol. 2000;21(5):701-705."},{"issue":"2","key":"bib2","series-title":"J Neurosurg","first-page":"192","article-title":"Dural sinus thrombosis and pseudotumor cerebri: unexpected complications of suboccipital craniotomy and translabyrinthine craniectomy","volume":"91","author":"Keiper","year":"1999","unstructured":"Keiper GLSherman JDTomsick TATew JM.Dural sinus thrombosis and pseudotumor cerebri: unexpected complications of suboccipital craniotomy and translabyrinthine craniectomy. J Neurosurg. 1999;91(2):192-197."},{"issue":"7","key":"bib3","series-title":"J NeuroIntervent Surg","first-page":"587","article-title":"A unifying theory explaining venous sinus stenosis and recurrent stenosis following venous sinus stenting in patients with idiopathic intracranial hypertension","volume":"13","author":"Fargen","year":"2021","unstructured":"Fargen KM.A unifying theory explaining venous sinus stenosis and recurrent stenosis following venous sinus stenting in patients with idiopathic intracranial hypertension. J NeuroIntervent Surg. 2021;13(7):587-592."},{"issue":"6","key":"bib4","series-title":"J Neuroradiol","first-page":"581","article-title":"Cerebral venous disorders: diagnosis and endovascular management","volume":"50","author":"Abdalkader","year":"2023","unstructured":"Abdalkader MHui FAmans MRCerebral venous disorders: diagnosis and endovascular management. J Neuroradiol. 2023;50(6):581-592."},{"issue":"4","key":"bib5","series-title":"Interv Neuroradiol","first-page":"524","article-title":"Technical and clinical success after venous sinus stenting for treatment of idiopathic intracranial hypertension using a novel guide catheter for access: case series and initial multi-center experience","volume":"30","author":"Zyck","year":"2024","unstructured":"Zyck SMalik MWebb MTechnical and clinical success after venous sinus stenting for treatment of idiopathic intracranial hypertension using a novel guide catheter for access: case series and initial multi-center experience. 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Stent survival and stent-adjacent stenosis rates following venous sinus stenting for idiopathic intracranial hypertension: a systematic review and meta-analysis. Interv Neurol. 2018;7(6):490-500."},{"issue":"9","key":"bib8","series-title":"J Neurointerv Surg","first-page":"867","article-title":"Dural sinus stenting for idiopathic intracranial hypertension: factors associated with hemodynamic failure and management with extended stenting","volume":"9","author":"Kumpe","year":"2017","unstructured":"Kumpe DASeinfeld JHuang XDural sinus stenting for idiopathic intracranial hypertension: factors associated with hemodynamic failure and management with extended stenting. J Neurointerv Surg. 2017;9(9):867-874."},{"key":"bib9","series-title":"BMJ Case Rep","first-page":"bcr2015011896","article-title":"Delayed relapse in pseudotumor cerebri due to new stenosis after transverse sinus stenting","volume":"2015","author":"Winters","year":"2015","unstructured":"Winters HSParker GHalmagyi GMMehta AAtkins T.Delayed relapse in pseudotumor cerebri due to new stenosis after transverse sinus stenting. BMJ Case Rep. 2015;2015:bcr2015011896."},{"issue":"8","key":"bib10","series-title":"AJNR Am J Neuroradiol","first-page":"1408","article-title":"Transverse sinus stenting for idiopathic intracranial hypertension: a review of 52 patients and of model predictions","volume":"32","author":"Ahmed","year":"2011","unstructured":"Ahmed RMWilkinson MParker GDTransverse sinus stenting for idiopathic intracranial hypertension: a review of 52 patients and of model predictions. 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