Case reportNew frontiers in venous sinus stenting: Illustrative cases

•Venous sinus stenting for atypical idiopathic intracranial hypertension (IIH) may alleviate symptoms.•Multiple telescoped stents can treat complex venous sinus stenosis.•Venous sinus stenosis stenting may ameliorate cognitive decline in atypical IIH.

Idiopathic intracranial hypertension (IIH) occurs rarely, with severe patients recalcitrant to pharmacologic management often requiring cerebrospinal fluid diversion. We report two patients with variant IIH successfully treated with venous sinus stenting: 1) A 65-year-old man with severe vision loss, papilledema, and cognitive decline treated with four telescoped stents across a long, severely stenotic transverse-sigmoid system, and 2) a 58-year-old woman with headaches, vision loss, and papilledema secondary to a jugular paraganglioma causing severe jugular bulb stenosis that required contralateral venous sinus stenting. At 3-month and 1-month follow-up, respectively, ophthalmologic examinations showed vision improvement. The first patient also had improved cognition, and the second patient also had improved headaches.