• Mahmoud H Mohammaden, Muhammad Rizwan Husain, Denise Brunozzi, Ahmed E Hussein, Gursant Atwal, Fady T Charbel, and Ali Alaraj.
• Department of Neurosurgery, University of Illinois at Chicago, Illinois.
• Neurosurgery. 2020 May 1; 86 (5): 631-636.

BackgroundThe resistivity index (RI) in cerebral venous sinus stenosis (VSS) has not been studied in patients with idiopathic intracranial hypertension (IIH).ObjectiveTo evaluate the role of RI measured by quantitative magnetic resonance venogram (QMRV) as a noninvasive tool in the diagnosis of venous hypertension associated with VSS in IIH.MethodsRetrospective evaluation of 13 consecutive IIH patients who underwent venous sinus stenting at our institution between 2013 and 2018.Patients' demographics, clinical presentation, cerebral mean venous sinus pressure (MVP), and RI both pre- and poststenting were recorded. The baseline RI was also compared to a control group.ResultsAmong 13 patients of IIH, 11 had unilateral VSS in dominant sinus, whereas 2 had bilateral VSS. RI was significantly higher in IIH patients compared to the control group in the superior sagittal (SSS) and transverse sinuses (TS) (0.21 vs 0.11, P = .01 and 0.22 vs 0.13, P = .03, respectively). The MVP (in mm Hg) decreased significantly after venous sinus stenting in the SSS (41.9 to 22.5, P < .001) and TS (39.4 to 19.5, P < .001), which was also associated with a significant reduction of the RI (0.22 vs 0.17, P < .01 in SSS and 0.23 vs 0.17, P = .03 in TS) poststenting.ConclusionRI calculated using QMRV can serve as a noninvasive tool to aid in the diagnosis of hemodynamically significant VSS. The study had a small sample size, and larger multicenter studies would be required to validate the results further.Copyright © 2019 by the Congress of Neurological Surgeons.

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