A Novel Case of Transverse Sinus Stenting and Ticagrelor Use During Pregnancy for Idiopathic Intracranial Hypertension

Abstract

Background Idiopathic intracranial hypertension (IIH) is prevalent among the US population, with exacerbation of symptoms during pregnancy. Transverse sinus stenting is a new effective treatment for IIH. Stenting is avoided in pregnancy largely due to the requirement of dual antiplatelet therapy. Methods We present a case of a pregnant patient in her first trimester with signs and symptoms of fulminant IIH, including progressive visual loss, who underwent placement of a transverse sinus stent and administration of dual antiplatelet therapy with ticagrelor. Results Ticagrelor was administered pre–operatively. The patient underwent venous sinus stenting for fulminant IIH. There were no complications. She had resolution of symptoms and underwent cesarean delivery without issues. Her child displayed no signs and symptoms of abnormalities. Conclusion Venous sinus stenting for IIH can be considered in pregnant patients presenting with new or worsening IIH with associated papilledema. The use of ticagrelor did not lead to any adverse outcomes for the patient or the fetus in our case.

Keywords

• idiopathic intracranial hypertension
• pregnancy
• pseudotumor
• sinus stenting
• ticagrelor