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Contralateral Hypoplastic Venous Draining Sinuses Are Associated with Elevated Intracranial Pressure in Unilateral
R Farias-Moeller1, R Avery1,2, Y Diab3
1From the Divisions of Child Neurology (R.F.-M., R.A., J.C.).
Insights
In pediatric cerebral sinovenous thrombosis, a smaller opposite venous sinus increases the risk of elevated intracranial pressure. This finding highlights potential complications in children with unilateral cerebral sinovenous thrombosis and hypoplastic sinuses.
Area of Science:
- Neurology
- Pediatric Radiology
- Vascular Anatomy
Background:
- Cerebral venous development variations impact drainage regulation.
- These variations are linked to elevated intracranial pressure in cerebral sinovenous thrombosis.
- Unilateral cerebral sinovenous thrombosis presents unique challenges in pressure management.
Purpose of the Study:
- To investigate the association between contralateral venous sinus size and elevated intracranial pressure in pediatric patients with unilateral cerebral sinovenous thrombosis.
- To determine if hypoplastic contralateral venous sinuses increase the risk of elevated intracranial pressure.
Main Methods:
- Retrospective review of pediatric patients diagnosed with unilateral cerebral sinovenous thrombosis.
- Analysis of institutional radiology database for case identification.
- Comparison of elevated intracranial pressure occurrence in patients with and without hypoplastic contralateral venous sinuses.
Main Results:
- Twelve cases of unilateral cerebral sinovenous thrombosis met inclusion criteria.
- Six patients (50%) had hypoplastic contralateral venous sinuses.
- Elevated intracranial pressure occurred in 83% of patients with hypoplastic sinuses versus 0% without (P = .015).
Conclusions:
- Hypoplastic contralateral venous sinuses in pediatric unilateral cerebral sinovenous thrombosis are associated with a significantly higher risk of elevated intracranial pressure.
- Patients with cerebral sinovenous thrombosis and contralateral venous sinus hypoplasia may require closer monitoring and potentially ophthalmologic screening.
- Understanding venous anatomy variations is crucial for managing intracranial pressure in pediatric cerebral sinovenous thrombosis.
Abstract:
Variations in cerebral venous development can influence the ability to regulate drainage. In cerebral sinovenous thrombosis, these variations can be associated with elevated intracranial pressure. We present a series of pediatric patients with unilateral cerebral sinovenous thrombosis and investigate whether the contralateral venous sinus size increases the risk of developing elevated intracranial pressure. Patients diagnosed with a unilateral cerebral sinovenous thrombosis were identified by querying our institutional radiology data base. The difference in the occurrence of elevated intracranial pressure in patients with cerebral sinovenous thrombosis with and without hypoplastic venous sinuses was studied. Twelve cases of unilateral cerebral sinovenous thrombosis met the inclusion criteria and had sufficient images. Six patients had hypoplastic contralateral venous sinuses. The presence of hypoplastic contralateral venous sinus in the setting of thrombosis of a dominant sinus was associated with elevation of intracranial pressure (83% versus 0%, P = .015). Patients with cerebral sinovenous thrombosis and contralateral hypoplastic venous sinuses are at higher risk of developing elevated ICP and may benefit from screening with an ophthalmologic examination.
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