Symptomatic cerebral venous outflow resistance responds to stenting even in the absence of intracranial hypertension on manometry: a multicentre study

The relative contribution of venous outflow obstruction and intracranial pressure (ICP) to symptomatology and treatment response in Idiopathic Intracranial Hypertension (IIH) remains uncertain. Venous sinus stenting (VSS) is indicated in patients with significant trans-stenotic pressure gradients (TPG) and concordant symptoms....

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Audiologists should be aware this finding is primarily neurology/interventional radiology territory; no direct change to audiology practice is warranted, but for patients presenting with pulsatile tinnitus or hearing symptoms potentially linked to idiopathic intracranial hypertension (IIH), awareness that venous stenting may benefit patients without confirmed manometric hypertension could inform referral conversations.

This multicentre finding may broaden eligibility criteria for venous sinus stenting in IIH-spectrum disorders, which occasionally intersect with audiology through pulsatile tinnitus and hearing complaints.

1. 01Multicentre study shows cerebral venous stenting can relieve symptoms even without elevated intracranial pressure on manometry.
2. 02Challenges current practice of requiring manometric hypertension before offering stenting.
3. 03Relevant to IIH management, a condition sometimes associated with pulsatile tinnitus.
4. 04Results suggest symptom burden, not manometry alone, may be a sufficient treatment trigger.
5. 05Peripheral relevance to audiology via pulsatile tinnitus differential diagnosis.

PMID

42684436

DOI

10.1007/s00234-026-04172-9.

Journal

Neuroradiology

Publication type

research_article

Evidence level

2b

Population

Patients with symptomatic cerebral venous outflow resistance, including those without intracranial hypertension on manometry

Intervention

Cerebral venous sinus stenting