Prevalence of Venous Sinus Stenosis in Spontaneous Cerebrospinal Fluid Leak and the Role for Venous Sinus Stenting: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Background: Current literature supports a strong association between spontaneous cerebrospinal fluid (sCSF) leak and idiopathic intracranial hypertension (IIH). There is also recent evidence which suggests a link between sCSF leak and venous sinus stenosis (VSS), a common feature found in IIH. This review aims to investigate the prevalence of VSS in sCSF leak as well as the role of venous sinus stenting for sCSF leak. Methods: A protocol was registered in PROSPERO [CRD42024568270] which searched for studies of sCSF leaks that also investigated the prevalence of VSS. A search was conducted in four electronic databases: Medline (Ovid), Embase, CINAHL, and Cochrane CENTRAL from inception until July 11, 2024. Two reviewers independently screened citations and extracted data. Methodological quality was assessed using the Joanna Briggs Institute’s critical appraisal tool. Data were pooled using a random effects model to calculate overall prevalence and relative risk (RR). Results: Thirteen studies met the final inclusion criteria with a total of 317 patients. The pooled prevalence of VSS in patients with sCSF leak was 0.71 (95% CI, 0.56–0.83, I 2 = 74%). In two studies which investigated the presence of VSS in patients with sCSF leak, sCSF leak was associated with a greater risk of underlying VSS (RR = 3.11; 95% CI, 0.64–15.27, I 2 = 87%), although this was not statistically significant. Eighty-five percent to 100% of patients with VSS who underwent venous sinus stenting as adjunctive therapy to surgical repair of sCSF leak or for medically refractive IIH demonstrated resolution of symptoms without sCSF leak recurrence at last follow-up. Conclusion: VSS is common in patients with sCSF leak and adjunctive venous sinus stenting after surgical leak repair may be a therapeutic option for a subset of sCSF patients with VSS. Further studies are needed to investigate the association of VSS in sCSF leak and clarify the role of venous sinus stenting in conjunction with surgical repair of leaks. Publication History Article published online: 07 February 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.013 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.020 |
| Bibliometrics | 0.004 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".