Venous Sinus Stenting for Challenging Cases of Idiopathic Intracranial Hypertension: A Case Series From a Tertiary Care Center in Riyadh, Saudi Arabia.

Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure that causes headaches and visual disturbances. While medical management is the primary treatment, some patients remain refractory. Venous sinus stenting (VSS) has emerged as a potential alternative. This case series discusses the outcomes of VSS in patients with refractory IIH. Patients with IIH who underwent VSS at a tertiary hospital in Riyadh were reviewed. The data collected included demographics, clinical presentation, diagnostic imaging findings, intraprocedural pressure measurements, and clinical and radiological outcomes before and after stenting. Verbal consent was obtained from all patients for participation in this case series. All patients demonstrated transverse sinus stenosis and had persistent symptoms despite medical therapy. Following VSS, all patients experienced significant improvements in intracranial pressure gradients, papilledema grades, visual symptoms, and the frequency and intensity of headaches. No procedural complications occurred, although one patient experienced transient worsening of symptoms after the procedure. This case series suggests that VSS may be an effective treatment for carefully selected patients with refractory IIH and can lead to improvements in clinical and radiological outcomes. However, larger, prospective, controlled studies with longer follow-ups are needed to confirm these findings and establish the long-term efficacy and safety of VSS.