Tumoral thrombosis of cerebral venous sinuses: Preoperative diagnosis using magnetic resonance phase imaging
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Cerebral veins
Dural venous sinuses
Dural venous sinuses
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Recent reports suggest an association between dural AVFs and cerebral venous thrombosis. We aimed to investigate the specific temporal and anatomic association between the 2 conditions.A consecutive cohort of adult patients with dural AVFs was seen at Amsterdam University Medical Centers (2007-2020). An experienced neuroradiologist re-evaluated the presence and imaging characteristics of dural AVFs and cerebral venous thrombosis on all available imaging. The temporal (previous/concurrent/subsequent) and anatomic (same/adjacent/unrelated venous sinus or vein) association between dural AVFs and cerebral venous thrombosis was determined.Among 178 patients with dural AVFs, the mean age was 58.3 (SD, 13.2) years and 85 (48%) were women. Of 55 patients (31%) with cerebral venous thrombosis, 34 (62%) were women. Four patients (7%) had cerebral venous thrombosis before the development of a dural AVF, 33 (60%) had cerebral venous thrombosis at the time of dural AVF diagnosis (concurrent), and 18 (33%) developed cerebral venous thrombosis during follow-up after conservative treatment. The incidence rate of cerebral venous thrombosis after a dural AVF was 79 per 1000 person-years (95% CI, 50-124). In 45 (82%) patients with dural AVFs and cerebral venous thrombosis, the thrombosis was located in the same venous sinus as the dural AVF, whereas in 8 (15%) patients, thrombosis occurred in a venous sinus adjacent to the dural AVF.One-third of patients with a dural AVF in this study were diagnosed with cerebral venous thrombosis. In almost two-thirds of patients, cerebral venous thrombosis was diagnosed prior to or concurrent with the dural AVF. In 97% of patients, there was an anatomic association between the dural AVF and cerebral venous thrombosis. These data support the hypothesis of a bidirectional association between the 2 diseases.
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Cerebral veins
Intracranial Thrombosis
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BACKGROUND AND PURPOSE: MR venography is often used to examine the intracranial venous system, particularly in the evaluation of dural sinus thrombosis. The purpose of this study was to evaluate the use of MR venography in the depiction of the normal intracranial venous anatomy and its variants, to assess its potential pitfalls in the diagnosis of dural venous sinus thrombosis, and to compare the findings with those of conventional catheter angiography. METHODS: Cerebral MR venograms obtained in 100 persons with normal MR imaging studies were reviewed to determine the presence or absence of the dural sinuses and major intracranial veins. RESULTS: Systematic review of the 100 cases revealed transverse sinus flow gaps in 31% of the cases, with 90% of these occurring in the nondominant transverse sinus and 10% in the codominant transverse sinuses. No flow gaps occurred in the dominant transverse sinuses. The superior sagittal and straight sinuses were seen in every venogram; the occipital sinus was seen in only 10%. The vein of Galen and internal cerebral veins were also seen in every case; the basal veins of Rosenthal were present in 91%. CONCLUSIONS: Transverse sinus flow gaps can be observed in as many as 31% of patients with normal MR imaging findings; these gaps should not be mistaken for dural sinus thrombosis.
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Dural venous sinuses
Cerebral veins
Sinus (botany)
Venography
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THROMBOSES of the dural sinuses give certain symptoms and signs dependent on the sinuses involved and the structures drained; these typical signs, however, may be modified by three separate conditions: first, the numerous collateral communications between sinuses and sinuses, and sinuses and veins; second, the anatomic variations in the position of the sinuses, and, third, the variations in size in the lateral sinuses; occasionally, one sinus may even be absent. On the presence of such anatomic variations, Woodhall1based the reasons for false positive and negative phenomena. Dural sinuses are sluggish venous channels first lying in the dural sheath and later becoming formed vessels. They collect blood from the brain and its coverings as they course centrad, finally to become the jugular vein; the sinuses connect one with the other and are given different names, dependent on their localization. With any thrombosis, there may be increased intracranial tension with
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The paper reviews air travel and venous thrombosis. The risk of venous thrombosis increases with distance flown. The mechanisms that cause thrombosis are unknown, but may be related to hypobaric hypoxia, i.e. reduced air pressure inside the aeroplane, stasis of the lower limbs, often referred to as economy class syndrome (ECS), and dehydration.Symptomless deep venous thrombosis may occur in 10% of healthy long-haul airline travellers over 50 years of age, and up to 4.5% of passengers under 50 at high risk of thrombosis. Wearing of elastic compression stockings during the flight is associated with reduced risk of deep venous thrombosis.Passengers should be encouraged to use the muscle-vein pump regularly, ensure adequate hydration, and in some cases wear elastic compression stockings. A majority of passengers will not need any thromboprophylaxis. Aspirin may have a protective role, but its efficacy in preventing venous thrombosis is much smaller than that of low molecular weight heparins. A high prophylactic dose of a low molecular weight heparin should be considered in passengers at high risk of thrombosis.
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Radiologic Diagnosis of Cerebral Venous Thrombosis: Pictorial ReviewColin S. Poon1 2, Ja-Kwei Chang1, Amar Swarnkar1, Michele H. Johnson2 and John Wasenko1Audio Available | Share
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