Self-reported cognitive dysfunction improves following venous sinus stenting

Background: Venous sinus stenting (VSS) is a well-established treatment for medically refractory venopathic intracranial hypertension (VIH), with consistent improvements reported in symptoms such as headache, papilledema, and pulsatile tinnitus. Cognitive dysfunction, however, remains underexplored in terms of burden and response to surgical intervention. Methods: A retrospective, single-center study was performed of patients that underwent VSS for VIH. Symptom severity was assessed using the Cerebral Venous Disorder Symptom Severity (CVDSS) scale. Scores were collected pre-operatively and post-operatively at 2 weeks and 6 weeks. Results: A total of 50 consecutive patients with a mean age of 35.7 years underwent venous sinus stent placement for VIH and were included. VSS resulted in a reduction of the average pressure gradient from 15.0 to 2.8 mmHg. Baseline CVDSS cognitive dysfunction scores were rated as moderate or severe in 84% of patients. Sixty-four percent of patients had improvement in cognitive dysfunction between baseline and 6-week post-operatively (OR 5.1 (95% CI: 2.2, 11.6)), with only 38% reporting ongoing moderate or severe cognitive dysfunction after stenting. Global symptom severity also demonstrated improvement at 6 weeks. Conclusion: Self-reported cognitive dysfunction is highly prevalent and often severe in patients with VIH. VSS is associated with significant improvement in short-term cognitive dysfunction scores in addition to global symptom severity.