Contact your treating team urgently for new or worsening vision changes. Sudden major vision loss, stroke symptoms, or a sudden severe headache needs emergency evaluation.
What is IIH?
Idiopathic intracranial hypertension, or IIH, means increased pressure around the brain without another identified cause. It is sometimes called pseudotumor cerebri. Symptoms may include headache, brief episodes of dim or blurred vision, double vision, and a pulse-like whooshing in the ears. Pressure can swell the optic nerves and threaten sight, so protecting vision is a central goal of care.
References: 1
How the diagnosis is confirmed
Evaluation includes a neurologic examination and an eye or neuro-ophthalmology assessment, including visual fields and optic nerve testing. Brain MRI with MR venography, or appropriate CT alternatives, helps assess the brain and venous sinuses and exclude causes such as a blood clot. When appropriate and safe after imaging, a lumbar puncture measures cerebrospinal fluid pressure and checks the fluid. A narrow venous sinus on a scan alone does not establish IIH or prove that a stent is needed.
References: 2
Treatment starts with your vision and overall health
Treatment may include supported weight management when appropriate, medicines such as acetazolamide to reduce fluid production, and a separate plan for headaches. Eye examinations track whether treatment is protecting sight. If vision is deteriorating, urgent specialist treatment may be needed, including a cerebrospinal fluid shunt or optic nerve sheath fenestration, an operation around the optic nerve. The choice depends on the pace of vision loss and your overall situation.
When venous sinus stenting may help
For selected patients with IIH and a functionally important narrowing in a venous sinus, a stent may be considered after specialist evaluation. Catheter cerebral venography examines the veins, and venous pressure manometry measures pressure differences across the narrowing. This is a different assessment from a routine arterial cerebral angiogram. The decision considers vision, pressure measurements, anatomy, prior treatment, and procedural risks. Stenting is not a routine treatment for headache alone.
Care after a venous sinus stent
Take prescribed antiplatelet medicines exactly as directed; do not stop them without your stenting team’s instructions. Follow-up may include eye testing and imaging, with repeat venography and pressure measurements if symptoms return. Possible complications include bleeding, vessel injury, clotting within the stent, and new or recurrent narrowing that may require further treatment. A successful procedure does not guarantee that every headache will resolve.
Common questions
Does every person with IIH need a stent?
No. Many patients are managed with medical treatment and weight management when appropriate. Stenting is considered only after the diagnosis, venous anatomy, pressure findings, and alternatives have been reviewed.
Is dural sinus stenting the same as treating the sinuses in my nose?
No. Dural venous sinuses are blood drainage channels around the brain. They are separate from the air-filled sinuses involved in nasal congestion or sinus infections.
References: 3
Will a cerebral angiogram measure my spinal fluid pressure?
A routine arterial angiogram does not measure spinal fluid opening pressure. Lumbar puncture measures that pressure; catheter venography with manometry measures pressure within the venous drainage channels when that information is needed.
Your next step
Sources & further reading
- National Eye Institute: Idiopathic Intracranial Hypertension ↗
- Austrian IIH network: Diagnosis, treatment and monitoring consensus recommendations (2025) ↗
- Fargen et al.: Recommendations for selection and treatment for venous sinus stenting (2018) ↗
- Townsend et al.: Major complications of dural venous sinus stenting (2022) ↗
This guide explains general care options. Your treating team will recommend an evaluation and treatment plan for your individual situation.