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Original research article


Cerebral Blood and CSF Flow Patterns in Patients Diagnosed for Cerebral Venous Thrombosis - An Observational Study

Souraya ElsankariMarek CzosnykaPierre LehmannMarc-Etienne MeyerHervé DeramondOlivier Balédent
Department of Imaging and Biophysics, Amiens University Hospital, 80054 Amiens Cedex France, Department of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium, Department of Clinical Neurosciences, Academic Neurosurgical Unit, University of Cambridge, Addenbrooke’s Hospital, Box 167 Cambridge, United Kingdom, Department of Radiology, Amiens University Hospital, 80054 Amiens Cedex France
Date of Submission: 31-Mar-2012, Date of Acceptance: 13-Apr-2012, Date of Web Publication: 28-Jul-2012.
Corresponding Author:
Corresponding Author

Souraya ElSankari

Department of Imaging and Biophysics, Centre Hospitalier Universitaire Nord, Place Victor Pauchet, 80054 Amiens cedex, France.
E-mail: sorayaelsankari560@hotmail.com

Corresponding Author:
Corresponding Author

Souraya ElSankari

Department of Imaging and Biophysics, Centre Hospitalier Universitaire Nord, Place Victor Pauchet, 80054 Amiens cedex, France.
E-mail: sorayaelsankari560@hotmail.com

DOI: 10.4103/2156-7514.99158 Facebook Twitter Google Linkedin

ABSTRACT



Background and Purpose: Recent studies of the organization of the cerebral venous system in healthy subjects using phase contrast magnetic resonance imaging (PCMRI) show its structural complexity and inter-individual variations. Our objective was to study the venous blood and CSF flows in cerebral venous thrombosis (CVT).
Materials and Methods: PC-MRI sequences were added to brain MRI conventional protocol in 19 patients suspected of CVT, among whom 6 patients had CVT diagnosis confirmed by MR venography. Results were compared with 18 healthy age-matched volunteers (HV).
Results: In patients without CVT (NoCVT) confirmed by venography, we found heterogeneous individual venous flows, and variable side dominance in paired veins and sinuses, comparable to those in healthy volunteers. In CVT patients, PC-MRI detected no venous flow in the veins and/or sinuses with thrombosis. Arterial flows were preserved. CSF aqueductal and cervical stroke volumes were increased in a patient with secondary cerebral infarction, and decreased in 4 patients with extended thrombosis in the superior sagittal and transverse sinuses. These results suggest the main role of the venous system in the regulation of the dynamic intracranial equilibrium.
Conclusions: CVT produces highly individualized pattern of disturbance in venous blood drainage. Complementary to MRI venography, PC-MRI provides non-invasive data about venous blockage consequences on CSF flow disturbances.
Keywords: CSF, Cerebral Venous Thrombosis, PC-MRI, Hydrodynamics, Veins

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  1. Audrey Arnoux, Aude Triquenot-Bagan, Daniela Andriuta, David Wallon, Evelyne Guegan-Massardier, Claire Leclercq, Olivier Martinaud, Mélody Castier-Amouyel, Olivier Godefroy and Jean-Marc Bugnicourt (2017) Imaging Characteristics of Venous Parenchymal Abnormalities. Stroke 48(12):3258. doi: 10.1161/STROKEAHA.117.017937
  2. Wen-hao Wang, Jun-ming Lin, Fei Luo, Lian-shui Hu, Jun Li and Wei Huang (2013) Early Diagnosis and Management of Cerebral Venous Flow Obstruction Secondary to Transsinus Fracture after Traumatic Brain Injury. J Clin Neurol 9(4):259. doi: 10.3988/jcn.2013.9.4.259
  3. S. Fall, G. Pagé, J. Bettoni, R. Bouzerar and O. Balédent (2017) Use of Phase-Contrast MRA to Assess Intracranial Venous Sinus Resistance to Drainage in Healthy Individuals. AJNR Am J Neuroradiol 38(2):281. doi: 10.3174/ajnr.A5013
  4. Clive B Beggs, Simon J Shepherd, Pietro Cecconi and Maria Marcella Lagana (2019) Predicting the Aqueductal Cerebrospinal Fluid Pulse: A Statistical Approach. Applied Sciences 9(10):2131. doi: 10.3390/app9102131
  5. Véronique Promelle, Joël Daouk, Roger Bouzerar, Benjamin Jany, Solange Milazzo and Olivier Balédent (2016) Ocular blood flow and cerebrospinal fluid pressure in glaucoma. Acta Radiologica Open 5(2):205846011562427. doi: 10.1177/2058460115624275
  6. Veronique Promelle, Roger Bouzerar, Solange Milazzo and Olivier Balédent (2018) Quantification of blood flow in the superior ophthalmic vein using phase contrast magnetic resonance imaging. Experimental Eye Research 176:40. doi: 10.1016/j.exer.2018.06.029
  7. Yasuo Murai, Ryo Takagi, Yasuo Amano, Tetsuro Sekine, Akio Morita and Akira Teramoto (2014) 4D Flow Preliminary Investigation for Anterior Fossa Dural Arteriovenous Fistula. Can. J. Neurol. Sci. 41(5):656. doi: 10.1017/cjn.2014.6
  8. Clive B. Beggs, Christopher Magnano, Simon J. Shepherd, Karen Marr, Vesela Valnarov, David Hojnacki, Niels Bergsland, Pavel Belov, Steven Grisafi, Michael G. Dwyer, Ellen Carl, Bianca Weinstock-Guttman and Robert Zivadinov (2014) Aqueductal cerebrospinal fluid pulsatility in healthy individuals is affected by impaired cerebral venous outflow. J. Magn. Reson. Imaging 40(5):1215. doi: 10.1002/jmri.24468
  9. Maria Marcella Laganà, Simon J. Shepherd, Pietro Cecconi and Clive B. Beggs (2017) Intracranial volumetric changes govern cerebrospinal fluid flow in the Aqueduct of Sylvius in healthy adults. Biomedical Signal Processing and Control 36:84. doi: 10.1016/j.bspc.2017.03.019

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