The impact of CSF venous fistula embolization on patient's quality of life, a longitudinal clinical-radiological exploration.

Résumé

BACKGROUND: Transvenous Onyx embolization of cerebrospinal fluid-venous fistulas (CSFVF) is an emerging and effective treatment for symptomatic spontaneous intracranial hypotension (SIH). This condition significantly impacts patients' quality of life (QoL) through a variety of debilitating symptoms.METHODS: Patients were selected from a prospective database of individuals with CSFVF who underwent transvenous Onyx embolization. All participants were asked to complete 13 questionnaires assessing their QoL, before and three months after treatment. Clinical and radiological data were retrospectively collected from the database, and the impact of embolization was evaluated across multiple variables. Correlations and stepwise regression analyses were used to explore relationships between QoL and specific domains including headache, audio-vestibular and psychological symptoms, and spiritual well-being.RESULTS: The study included 30 patients (mean age: 60.4 ± 14.1; female-to-male ratio: 2:1) diagnosed with SIH and CSFVF, that were treated successfully with Onyx embolization. There was no treatment-related morbidity. All 28 patients with headache reported symptom improvement, with 64% achieving complete resolution. The response rate was 100% for VAS-QoL, HIT-6, MIDAS grade, VAS-HI, and monthly headache days; lower rates were observed for SF-36 (56.6%), MSQ (96.7%), DHI and THI (90%), and psychological questionnaires (80-90%). Global QoL scores (VAS-QoL: p