Top

BMC Neurology

Published in:

Open Access 01-12-2020 | Intracranial Hypertension | Case report

Venous sinus stenting improves cerebral autoregulation in a patient with venous sinus stenosis: a case report

Authors: Meiyan Jia, Zhen-Ni Guo, Hang Jin, Xiuli Yan, Mingchao Shi, Xin Sun, Hongyin Ma, Shan Lv, Yi Yang

Published in: BMC Neurology | Issue 1/2020

Abstract

Background

Venous sinus stenosis (VSS) is a type of cerebral venous vascular disease. Cerebral autoregulation is an indicator of cerebral arterial function. The cerebral circulatory system is composed of the venous system and arterial system. Impaired venous function may affect arterial function. Thus, cerebral venous stenosis may influence cerebral autoregulation.

Case presentation

In this case, a 50-year-old woman with transient blindness and headache was admitted to the hospital. The patient was diagnosed with VSS. A stent was placed at the stenosis. The stent released the intravenous pressure and remitted the patient’s symptoms. Measurements of dynamic cerebral autoregulation (dCA) were performed at 3 time points: before stenting, after stenting, and 3 months later. The dCA gradually improved after stenting.

Conclusion

VSS may have an influence on cerebral autoregulation, and effective treatment improves cerebral autoregulation in patients with VSS.

Guo ZN, Xing Y, Wang S, Ma H, Liu J, Yang Y. Characteristics of dynamic cerebral autoregulation in cerebral small vessel disease: diffuse and sustained. Sci Rep. 2015;5:15269. https://doi.org/10.1038/srep15269.CrossRefPubMedPubMedCentral

Ma H, Guo ZN, Liu J, Xing Y, Zhao R, Yang Y. Temporal course of dynamic cerebral autoregulation in patients with Intracerebral hemorrhage. Stroke. 2016;47(3):674–81. https://doi.org/10.1161/STROKEAHA.115.011453.CrossRefPubMed

Wang S, Guo ZN, Xing Y, Ma H, Jin H, Liu J, et al. Dynamic Cerebral Autoregulation in Asymptomatic Patients With Unilateral Middle Cerebral Artery Stenosis. Medicine (Baltimore). 2015;94(52):e2234. https://doi.org/10.1097/MD.0000000000002234.CrossRef

Schaller B, Graf R. Cerebral venous infarction: the pathophysiological concept. Cerebrovasc Dis. 2004;18(3):179–88. https://doi.org/10.1159/000079939.CrossRefPubMed

Aaslid R, Lindegaard KF, Sorteberg W, Nornes H. Cerebral autoregulation dynamics in humans. Stroke. 1989;20(1):45–52.CrossRef

Claassen JA, Meel-van den Abeelen AS, Simpson DM, Panerai RB. Transfer function analysis of dynamic cerebral autoregulation: A white paper from the International Cerebral Autoregulation Research Network. J Cereb Blood Flow Metab. 2016;36(4):665–80. https://doi.org/10.1177/0271678x15626425.CrossRefPubMedPubMedCentral

Giller CA. The frequency-dependent behavior of cerebral autoregulation. Neurosurgery. 1990;27(3):362–8.CrossRef

Higgins JN, Cousins C, Owler BK, Sarkies N, Pickard JD. Idiopathic intracranial hypertension: 12 cases treated by venous sinus stenting. J Neurol Neurosurg Psychiatry. 2003;74(12):1662–6.CrossRef

Ahmed RM, Wilkinson M, Parker GD, Thurtell MJ, Macdonald J, McCluskey PJ, et al. Transverse sinus stenting for idiopathic intracranial hypertension: a review of 52 patients and of model predictions. AJNR Am J Neuroradiol. 2011;32(8):1408–14. https://doi.org/10.3174/ajnr.A2575.CrossRefPubMed

10.

Albuquerque FC, Dashti SR, Hu YC, Newman CB, Teleb M, McDougall CG, et al. Intracranial venous sinus stenting for benign intracranial hypertension: clinical indications, technique, and preliminary results. World Neurosurg. 2011;75(5–6):648–52; discussion 592-5. https://doi.org/10.1016/j.wneu.2010.11.012.CrossRefPubMed

11.

Fields JD, Javedani PP, Falardeau J, Nesbit GM, Dogan A, Helseth EK, et al. Dural venous sinus angioplasty and stenting for the treatment of idiopathic intracranial hypertension. J Neurointerv Surg. 2013;5(1):62–8. https://doi.org/10.1136/neurintsurg-2011-010156.CrossRefPubMed

12.

Qiu MJ, Chen ZC, Song SJ, Mao SY. Dural Venous Sinus Angioplasty and Stenting for Treatment of Idiopathic Intracranial Hypertension. Chin Med J. 2017;130(7):879–80. https://doi.org/10.4103/0366-6999.202736.CrossRefPubMedPubMedCentral

13.

Puffer RC, Mustafa W, Lanzino G. Venous sinus stenting for idiopathic intracranial hypertension: a review of the literature. J Neurointerv Surg. 2013;5(5):483–6. https://doi.org/10.1136/neurintsurg-2012-010468.CrossRefPubMed

14.

Giridharan N, Patel SK, Ojugbeli A, Nouri A, Shirani P, Grossman AW, et al. Understanding the complex pathophysiology of idiopathic intracranial hypertension and the evolving role of venous sinus stenting: a comprehensive review of the literature. Neurosurg Focus. 2018;45(1):E10. https://doi.org/10.3171/2018.4.Focus18100.CrossRefPubMed

15.

Nicholson P, Brinjikji W, Radovanovic I, Hilditch CA, Tsang ACO, Krings T, et al. Venous sinus stenting for idiopathic intracranial hypertension: a systematic review and meta-analysis. J Neurointerv Surg. 2019;11(4):380–5. https://doi.org/10.1136/neurintsurg-2018-014172.CrossRefPubMed

16.

Arai H, Sato K, Okuda, Miyajima M, Hishii M, Nakanishi H, et al. Transcranial transsphenoidal approach for tuberculum sellae meningiomas. Acta Neurochir. 2000;142(7):751–6 discussion 6-7.CrossRef

17.

Schmidek HH, Auer LM, Kapp JP. The cerebral venous system. Neurosurgery. 1985;17(4):663–78.CrossRef

18.

Gotoh M, Ohmoto T, Kuyama H. Experimental study of venous circulatory disturbance by dural sinus occlusion. Acta Neurochir. 1993;124(2–4):120–6.CrossRef

19.

Ueda K, Nakase H, Miyamoto K, Otsuka H, Sakaki T. Impact of anatomical difference of the cerebral venous system on microcirculation in a gerbil superior sagittal sinus occlusion model. Acta Neurochir. 2000;142(1):75–82.CrossRef

20.

Frerichs KU, Deckert M, Kempski O, Schurer L, Einhaupl K, Baethmann A. Cerebral sinus and venous thrombosis in rats induces long-term deficits in brain function and morphology--evidence for a cytotoxic genesis. J Cereb Blood Flow Metab. 1994;14(2):289–300. https://doi.org/10.1038/jcbfm.1994.36.CrossRefPubMed

21.

Ferro JM, Canhao P, Aguiar de Sousa D. Cerebral venous thrombosis. Presse Med. 2016;45(12 Pt 2):e429–e50. https://doi.org/10.1016/j.lpm.2016.10.007.CrossRefPubMed

22.

Kotani J, Adachi R, Fujita N, Sugioka S, Ueda Y. Effect of cerebral venous congestion on the pressure-volume index in the evaluation of intracranial pressure dynamics. J Neurosurg Anesthesiol. 1993;5(2):121–6.CrossRef

23.

Marmarou A, Shulman K, LaMorgese J. Compartmental analysis of compliance and outflow resistance of the cerebrospinal fluid system. J Neurosurg. 1975;43(5):523–34. https://doi.org/10.3171/jns.1975.43.5.0523.CrossRefPubMed

24.

Chai PJ, Skaryak LA, Ungerleider RM, Greeley WJ, Kern FH, Schulman SR, et al. Jugular ligation does not increase intracranial pressure but does increase bihemispheric cerebral blood flow and metabolism. Crit Care Med. 1995;23(11):1864–71.CrossRef

25.

Kurokawa Y, Hashi K, Okuyama T, Uede T. Regional ischemia in cerebral venous hypertension due to embolic occlusion of the superior sagittal sinus in the rat. Surg Neurol. 1990;34(6):390–5.CrossRef

26.

de-Lima-Oliveira M, Salinet ASM, Nogueira RC, de Azevedo DS, Paiva WS, Teixeira MJ, et al. Intracranial Hypertension and Cerebral Autoregulation: A Systematic Review and Meta-Analysis. World Neurosurg. 2018;113:110–24. https://doi.org/10.1016/j.wneu.2018.01.194.CrossRefPubMed

27.

Dias C, Silva MJ, Pereira E, Silva S, Cerejo A, Smielewski P, et al. Post-traumatic multimodal brain monitoring: response to hypertonic saline. J Neurotrauma. 2014;31(22):1872–80. https://doi.org/10.1089/neu.2014.3376.CrossRefPubMed

28.

Cremer OL, van Dijk GW, Amelink GJ, de Smet AM, Moons KG, Kalkman CJ. Cerebral hemodynamic responses to blood pressure manipulation in severely head-injured patients in the presence or absence of intracranial hypertension. Anesth Analg. 2004;99(4):1211–7, table of contents. https://doi.org/10.1213/01.ane.0000133917.67728.2a.CrossRefPubMed

29.

Hlatky R, Valadka AB, Robertson CS. Analysis of dynamic autoregulation assessed by the cuff deflation method. Neurocrit Care. 2006;4(2):127–32. https://doi.org/10.1385/ncc:4:2:127.CrossRefPubMed

30.

Hlatky R, Valadka AB, Robertson CS. Intracranial pressure response to induced hypertension: role of dynamic pressure autoregulation. Neurosurgery. 2005;57(5):917–23 discussion −23.CrossRef

31.

De Simone R, Ranieri A, Montella S, Bilo L, Cautiero F. The role of dural sinus stenosis in idiopathic intracranial hypertension pathogenesis: the self-limiting venous collapse feedback-loop model. Panminerva Med. 2014;56(3):201–9.PubMed

Title: Venous sinus stenting improves cerebral autoregulation in a patient with venous sinus stenosis: a case report
Authors: Meiyan Jia
Zhen-Ni Guo
Hang Jin
Xiuli Yan
Mingchao Shi
Xin Sun
Hongyin Ma
Shan Lv
Yi Yang
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Intracranial Hypertension
Published in: BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-019-1595-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Venous sinus stenting improves cerebral autoregulation in a patient with venous sinus stenosis: a case report

Abstract

Background

Case presentation

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2020

Cytokine changes during treatment of anti-Caspr2 encephalitis: a case report

Oral neuromuscular training in patients with dysphagia after stroke: a prospective, randomized, open-label study with blinded evaluators

The prediction of acute ischemic stroke patients’ long-term functional outcomes treated with bridging therapy

Increased recurrent risk did not improve cerebrovascular disease survivors’ response to stroke in China: a cross-sectional, community-based study

Use of analgesics in acute stroke patients with inability to self-report pain: a retrospective cohort study

Risk factors for neurological complications in severe and rigid spinal deformity correction of 177 cases