Treatment of intracranial hypertension secondary to superior sagittal sinus stenosis from invasive meningioma

Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure without a clear cause, often linked to cerebral venous sinus constriction from embryological or acquired factors. Although less common, brain tumors like parasagittal meningiomas can compress the superior sagittal sinus, leading to IIH. Venous stenting has become a minimally invasive and effective intervention for managing IIH caused by superior sagittal sinus stenosis, particularly when residual meningiomas continue to exert pressure on the sinus.1–6 Video 1 presents a step-by-step technique for deploying dual Onyx cardiac stents to treat stenosis in the superior sagittal sinus, which is complemented by middle meningeal artery embolization. This helps to reduce the vascular supply to the remaining meningioma tissue. This combined approach not only provides immediate relief from IIH symptoms but also minimizes surgical risks, such as venous infarction and excessive blood loss. It serves as a valuable adjunct in cases where complete surgical tumor removal is challenging. Video 1 - Techinical video of a case of superior sagittal sinus stenosis from an invasive meningioma causing intracranial hypertension successfully treated with a coronary balloon mounted stent.­