Diagnosis of Transverse Sinus Hypoplasia in Magnetic Resonance Venography

Han, Ke; Chao, A-Ching; Chang, Fan‐Ren; Hsu, Hung‐Yi; Chung, Chih‐Ping; Sheng, Wen‐Yung; Chan, Lung; Wu, Jiang; Hu, Han‐Hwa

doi:10.1097/md.0000000000002862

Cited by 19 publications

(13 citation statements)

References 16 publications

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“…The right transverse sinus is usually larger than the left and asymmetry of the transverse sinuses is not uncommon [ 12 ]. Unilateral hypoplasia or aplasia, which was also found in the present study, can be observed in 20% to 39% of cases [ 12 - 14 ]. In this study, the mean diameter of the transverse sinus was 6.21 mm and 6.30 mm on right and left sides, respectively.…”

Section: Discussionsupporting

confidence: 87%

Intraluminal anatomy of the transverse sinus: implications for endovascular therapy

et al. 2020

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Trabeculae or septations in the transverse sinus can have potentially life-threatening clinical significance. The current study demonstrates trabecula/septum patterning within the transverse sinus with measurements and distribution data supplemented by imaging, and describes the possible etiology of idiopathic intracranial hypertension and turbulent blood flow in the transverse sinus. Twenty-four sides from 12 cadaveric heads, all fresh-frozen, were used (five males, seven females; age at death 65-91 years, mean 79.1 years). The length and diameter of the transverse sinus were measured along with the number and locations of septations/trabeculae and their tensile strength. The mean length of the transverse sinus was 68.43 mm on the right side and 74.31 mm on the left. A total of 42 septations were found in the 24 transverse sinuses. The number of septations per side ranged from zero to four with a mean of 1.75. The septations were located in the proximal 1/3 in 54.8% (23/42), the middle 1/3 in 21.4% (9/42), and the distal 1/3 in 23.8% (10/42). The work presented here furthers our understanding of transverse sinus anatomy, including its detailed internal architecture. The measurements can provide a technical guide for neurosurgeons and influence instrument selection when a large thrombus forms or anchors in one of these trabeculae or septa and necessitates treatment.

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Section: Discussionsupporting

confidence: 87%

Intraluminal anatomy of the transverse sinus: implications for endovascular therapy

et al. 2020

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“…The detailed distribution of subjects with and without TS hypoplasia was reported in Table 1 of our previous paper [10]. In summary, 38% (17), 33% (8), 43% (9) and 68% (28) of the subjects with TGA, TMB, panic disorder, and controls, respectively, are with no TS hypoplasia.…”

Section: Resultsmentioning

confidence: 91%

“…Recently, asymmetry of the TS was successfully measured using magnetic resonance venography (MRV) and contrast T1-weighted magnetic resonance imaging (contrast T1) in transient global amnesia (TGA) and transient monocular blindness (TMB) [ 8 , 9 ]. Furthermore, two types of TS hypoplasia (anatomical TS hypoplasia and flow-related TS hypoplasia) were recently distinguished using a post-hoc analysis of the discrepancy and conformance of TS diameters measured by MRV and contrast T1 [ 10 ]. While anatomical TS hypoplasia is associated with TS diameter conformance, flow-related TS hypoplasia only appears on MRV due to downstream internal jugular vein (IJV) or brachiocephalic vein (BCV) compression/stenosis, and has been associated with neurological disorders of venous outflow impairment [ 8 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, two types of TS hypoplasia (anatomical TS hypoplasia and flow-related TS hypoplasia) were recently distinguished using a post-hoc analysis of the discrepancy and conformance of TS diameters measured by MRV and contrast T1 [ 10 ]. While anatomical TS hypoplasia is associated with TS diameter conformance, flow-related TS hypoplasia only appears on MRV due to downstream internal jugular vein (IJV) or brachiocephalic vein (BCV) compression/stenosis, and has been associated with neurological disorders of venous outflow impairment [ 8 – 10 ]. However, previous TS hypoplasia studies reporting adverse neurological effects included both the anatomical TS hypoplasia and flow-related TS hypoplasia and did not pay attention to the outflow impairment [ 4 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound diagnosis of transverse sinus hypoplasia using flow profiles of the internal jugular vein

et al. 2017

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Accurate diagnosis of subtypes of transverse sinus (TS) hypoplasia requires more expensive methods like magnetic resonance (MR) imaging. We hypothesized ultrasound findings of the internal jugular vein (IJV) can be surrogate indicators for diagnosis of TS hypoplasia. MR images were reviewed in 131 subjects to evaluate TS diameter and the location and degree of venous flow stenosis and obstruction. Ultrasound parameters including the cross-sectional lumen area (CSA), time-average-mean velocity (TAMV), and flow volume (FV) at each IJV segment were also evaluated. Sixty-nine subjects had TS hypoplasia based on MRV criteria, of which 39 TS hypoplasia were considered a subtype of TS hypoplasia, which is secondary to the downstream venous compression/stenosis or left brachiocephalic vein. In the ultrasound study, the CSA of the IJV ipsilateral to TS hypoplasia was significantly smaller. Further, a contralateral/ipsilateral IJV CSA ratio >1.55 provided good sensitivity, specificity, and positive predictive value for discriminating TS hypoplasia.

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“…Even neurological disorders that used to be assumed to have nothing to do with the vasculature, including multiple sclerosis and normal pressure hydrocephalus, now have been shown to involve venous hemodynamic mechanisms (Beggs, 2013). Interestingly, special MR sequence revealed that some neurological disorders, such as transient monocular blindness, panic disorder and transient global amnesia were correlated with transverse sinus hypoplasia (Han et al, 2016). Hence, it is now gradually being accepted that venous congestion and insufficiency not only affects the regional blood movement, but also the circulation of CSF, and overall brain metabolism and functional activity (Beard et al, 2015; Muir and Macrae, 2016).…”

Section: The Importance Of Identifying Cerebral Venous System Alteratmentioning

confidence: 99%

Cerebral venous collaterals: A new fort for fighting ischemic stroke?

Tong

Guo

et al. 2018

Progress in Neurobiology

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Stroke therapy has entered a new era highlighted by the use of endovascular therapy in addition to intravenous thrombolysis. However, the efficacy of current therapeutic regimens might be reduced by their associated adverse events. For example, over-reperfusion and futile recanalization may lead to large infarct, brain swelling, hemorrhagic complication and neurological deterioration. The traditional pathophysiological understanding on ischemic stroke can hardly address these occurrences. Accumulating evidence suggests that a functional cerebral venous drainage, the major blood reservoir and drainage system in brain, may be as critical as arterial infusion for stroke evolution and clinical sequelae. Further exploration of the multi-faceted function of cerebral venous system may add new implications for stroke outcome prediction and future therapeutic decision-making. In this review, we emphasize the anatomical and functional characteristics of the cerebral venous system and illustrate its necessity in facilitating the arterial infusion and maintaining the cerebral perfusion in the pathological stroke content. We then summarize the recent critical clinical studies that underscore the associations between cerebral venous collateral and outcome of ischemic stroke with advanced imaging techniques. A novel three-level venous system classification is proposed to demonstrate the distinct characteristics of venous collaterals in the setting of ischemic stroke. Finally, we discuss the current directions for assessment of cerebral venous collaterals and provide future challenges and opportunities for therapeutic strategies in the light of these new concepts.

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Diagnosis of Transverse Sinus Hypoplasia in Magnetic Resonance Venography

Cited by 19 publications

References 16 publications

Intraluminal anatomy of the transverse sinus: implications for endovascular therapy

Intraluminal anatomy of the transverse sinus: implications for endovascular therapy

Ultrasound diagnosis of transverse sinus hypoplasia using flow profiles of the internal jugular vein

Cerebral venous collaterals: A new fort for fighting ischemic stroke?

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