Cerebral venous congestion correlates to acute aneurysm rupture: An illustrative case with Doppler ultrasonography study.
Journal
eNeurologicalSci
ISSN: 2405-6502
Titre abrégé: eNeurologicalSci
Pays: Netherlands
ID NLM: 101667077
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
22
01
2019
revised:
01
01
2020
accepted:
17
02
2020
entrez:
18
3
2020
pubmed:
18
3
2020
medline:
18
3
2020
Statut:
epublish
Résumé
The objective of our description is to shed light on some new hemodynamic and clinical characteristics in the unstable cerebral aneurysm Case: We describe a 54 year old woman who presented a tension headache, that increasing for several days. A CT scan performed in ER suggests a possible arterial ectasia at the level of the circle of Willis. The patient is hospitalized. An angio CT shows an aneurysm of the anterior communicating artery, without signs of fixation and/or other instability. A subsequent TCCD examination with venous study shows clear congestion at the level of the spheno-parietal sinus. The Valsalva maneuver determines an increase in local congestion. In the light of the ultrasound picture, the patient was quickly received in Neurosurgery with success. we describe a clinical case where the worsening tension headache was not secondary to the increase of volume of the aneurysm but was an epiphenomenon of venous congestion, explored with TCCD. The mass effect of the aneurysm determined venous sinus compression and changed the hemodynamic of the cerebral venous flow. We believe that venous outflow obstruction and a high intracranial venous pressure gradient may be a cerebral aneurysm rupture factor.
Sections du résumé
BACKGROUND
BACKGROUND
The objective of our description is to shed light on some new hemodynamic and clinical characteristics in the unstable cerebral aneurysm Case: We describe a 54 year old woman who presented a tension headache, that increasing for several days. A CT scan performed in ER suggests a possible arterial ectasia at the level of the circle of Willis. The patient is hospitalized. An angio CT shows an aneurysm of the anterior communicating artery, without signs of fixation and/or other instability. A subsequent TCCD examination with venous study shows clear congestion at the level of the spheno-parietal sinus. The Valsalva maneuver determines an increase in local congestion. In the light of the ultrasound picture, the patient was quickly received in Neurosurgery with success.
CONCLUSION
CONCLUSIONS
we describe a clinical case where the worsening tension headache was not secondary to the increase of volume of the aneurysm but was an epiphenomenon of venous congestion, explored with TCCD. The mass effect of the aneurysm determined venous sinus compression and changed the hemodynamic of the cerebral venous flow. We believe that venous outflow obstruction and a high intracranial venous pressure gradient may be a cerebral aneurysm rupture factor.
Identifiants
pubmed: 32181376
doi: 10.1016/j.ensci.2020.100231
pii: S2405-6502(20)30010-1
pii: 100231
pmc: PMC7066058
doi:
Types de publication
Case Reports
Langues
eng
Pagination
100231Informations de copyright
© 2020 The Authors.
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