Left temporal hemorrhage caused by cerebral venous reflux of a brachio-brachial hemodialysis fistula

Haruma, Jun; Escalard, Simon; Smajda, Stanislas; Piotin, Michel

doi:10.1007/s00234-020-02457-1

Cited by 9 publications

(18 citation statements)

References 10 publications

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“…It is defined as >50% lesion (stenosis or occlusion) in one of the following central veins of the chest: inferior and superior vena cava, brachiocephalic vein (BCV), subclavian vein (SCV), or internal jugular vein (IJV). 1 Its clinical presentation varies depending on the site of the injury, being more serious the closer it is to the right atrium. It typically manifests with ipsilateral upper limb and facial edema, although it can occur asymptomatically.…”

Section: Introductionmentioning

confidence: 99%

“…Central venous disease (CVD) is a serious complication in patients undergoing hemodialysis. It is defined as >50% lesion (stenosis or occlusion) in one of the following central veins of the chest: inferior and superior vena cava, brachiocephalic vein (BCV), subclavian vein (SCV), or internal jugular vein (IJV) [ 1 ]. Its clinical presentation varies depending on the site of the injury, being more serious the closer it is to the right atrium.…”

Section: Introductionmentioning

confidence: 99%

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Central Venous Reflux, a Rare Cause of Neurological Manifestations in Hemodialysis Patients: A Case Report and Literature Review

et al. 2022

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Central venous disease (CVD) is a serious complication in hemodialysis patients. Neurological manifestations are rare. We describe a female with end-stage renal disease with throbbing headache accompanied by paresthesia, weakness, and abnormal posture of her right hand during dialysis sessions. Motor symptoms completely resolved after each dialysis session, although the headaches persisted for several hours. No neurological deficit was evidenced on physical examination. Digital subtraction angiography identified an incomplete thrombosis of the left brachiocephalic vein with retrograde flow in the internal jugular vein, sigmoid sinus, and transverse sinus on the left side. This case illustrates that cerebral venous congestion due to CVD can produce neurological symptoms. Furthermore, we systematically review the literature to identify the characteristics of the cases described so far. This allows clinicians to know the entity and have a high index of suspicion in a hemodialysis patient who develops neurological symptoms.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Central Venous Reflux, a Rare Cause of Neurological Manifestations in Hemodialysis Patients: A Case Report and Literature Review

et al. 2022

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“…A review of the literature yielded at least 15 publications reporting neurological signs and symptoms related to venous hypertension caused by altered cervical and cerebral blood flow from central vein access for hemodialysis. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Most of these cases clinically manifested with visual changes and papilledema suggesting a more typical presentation of elevated intracranial pressure, while others presented in a manner similar to our patient with seizures, hemorrhages, ischemic events, and encephalopathy. The time from venous access placement to onset of symptoms was extremely variable, suggesting that this condition needs to be considered in patients with such venous access regardless of when the procedure was performed as long as it is still patent.…”

Section: Discussionmentioning

confidence: 93%

Reversible Encephalopathy Due to Venous Hypertension From Arteriovenous Hemodialysis Graft

Mazzola

Ramineni

Burns

et al. 2020

The Neurohospitalist

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Venous congestive encephalopathy is a rare complication in patients with arteriovenous hemodialysis grafts. It commonly manifests as encephalopathy of fluctuating severity, often with seizures. Because these patients typically have multiple significant chronic health problems, venous hypertension’s contribution to the patient’s cognitive decline can easily be overlooked. This nonspecific presentation can make diagnosis challenging, therefore delaying treatment. We describe a case of progressive, fluctuating encephalopathy with seizures due to cerebral venous congestion caused by arterial shunting from an upper limb arteriovenous (AV) fistula to the proximal venous system, that was initially unrecognized, yet ultimately reversed by elimination of the source of venous hypertension.

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“…The diagnosis of CVS/CVO can be established with venography, and lumbar puncture with an opening pressure can confirm intracranial hypertension [ 6 ]. Measuring venous pressures during venography can also quantitatively assess venous hypertension, and post-treatment measurements can be used to confirm the success of intervention [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment success depends heavily upon early detection. Prompt discovery and intervention – especially before the onset of hemorrhage – has been shown to effectively allow for the resolution of focal neurological deficits [ 3 , 8 , 9 , 12 ]. Nevertheless, timely diagnosis of venous congestive encephalopathy proves especially difficult considering its non-specific – and sometimes neurologically unremarkable – presentations such as intermittent headaches early in the disease course [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Intracranial hemorrhage due to central venous occlusion from hemodialysis access: A case report

Mirza

Schwertner

Kohlbrenner

et al. 2021

Interdisciplinary Neurosurgery

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Central venous stenosis in hemodialysis patients rarely causes venous hypertension and intracranial hemorrhage. A 54 year-old male with right arm arteriovenous fistula was transferred to our institution in a comatose state following right parietal venous infarction. Fistulography showed right brachiocephalic vein (BCV) occlusion with reflux into the right transverse sinus and obstruction of left internal jugular vein outflow due to the styloid process. Balloon venoplasty of the right BCV occlusion failed to improve the patient’s status because of the delayed diagnosis. Headaches and neurologic symptoms in hemodialysis patients can herald intracranial hypertension due to central venous occlusion and needs prompt assessment with fistulography.

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Left temporal hemorrhage caused by cerebral venous reflux of a brachio-brachial hemodialysis fistula

Cited by 9 publications

References 10 publications

Central Venous Reflux, a Rare Cause of Neurological Manifestations in Hemodialysis Patients: A Case Report and Literature Review

Central Venous Reflux, a Rare Cause of Neurological Manifestations in Hemodialysis Patients: A Case Report and Literature Review

Reversible Encephalopathy Due to Venous Hypertension From Arteriovenous Hemodialysis Graft

Intracranial hemorrhage due to central venous occlusion from hemodialysis access: A case report

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