Venous Sinus Stent Placement Reduces Dosage Requirements for Carbonic Anhydrase Inhibitors in Patients with Idiopathic Intracranial Hypertension

Abstract

This study evaluates how the dosage (Acetazolamide and Topiramate) and need for medication changes pre and post venous sinus stent placement (VSS) for Idiopathic Intracranial Hypertension (IIH). This is a retrospective single center study. Adults diagnosed with IIH who failed optimized medical management treated with VSS were included. This study comprised 55 patients who underwent VSS for the diagnosis of IIH. The median preprocedural dosage of Acetazolamide and Topiramate was 1000.0 (500-4000) mg and 100.0 (0-200) mg among patients able to tolerate the medication. The median postprocedural dosage of Acetazolamide and Topiramate was 375 mg (0-4000) with a mean reduction of 52.9% (P=0.001) and 0.0 mg (0-200) with a mean reduction of 45.9% (P=0.005). Patients who underwent VSS on Acetazolamide and or Topiramate required a significantly reduced dosage post procedure which has the potential to reduce the morbidity secondary to medication side effects