Related Experiment Video
Updated: Sep 6, 2026
Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
Published on: December 9, 2022
Impaired venous outflow in CVST: prognostic implications of non-functional transverse sinus in a multicentre cohort
Jeremy Molad1,2, Ruth Eliahou3, Naaem Simaan4,5
1Department of Neurology & Stroke, Tel Aviv Sourasky Medical Center, Tel Aviv-Yafo, Israel.
Background And Objectives:
Non-functional transverse sinus (NFTS) represents a markedly narrowed but non-thrombosed transverse sinus that may impair cerebral venous outflow. Its influence on the clinical course and outcomes of cerebral venous sinus thrombosis (CVST) remains unclear. This study aimed to evaluate the prevalence and prognostic significance of NFTS among patients with CVST.
Methods:
Data from consecutively enrolled patients with confirmed CVST in multicentre databases were retrospectively analysed. NFTS was defined as a transverse sinus showing severe luminal reduction compared with the contralateral side in the absence of thrombosis. Patients with and without NFTS were compared for clinical and radiological features and 90-day excellent functional outcome, defined as a modified Rankin Scale score of 0-1. A preplanned secondary analysis included only patients with unilateral transverse sinus thrombosis sparing the NFTS to isolate its haemodynamic impact.
Results:
Among 443 CVST patients (mean age 41.4±18.2 years; 64.3% female), 49 (11%) had NFTS. Compared with those without NFTS, affected patients had higher rates of papilledema (50% vs 23%, p<0.001) and multiple cerebral vein involvement (43% vs 22%, p=0.002), with a trend towards lower rates of excellent 90-day outcome (78% vs 87%, p=0.067). In the secondary analysis of 299 patients with unilateral transverse sinus thrombosis not involving NFTS, NFTS (n=29) was associated with more papilledema (51.3% vs 24.3%, p<0.001), multiple vein involvement (51.3% vs 31.9%, p=0.017) and superior sagittal sinus thrombosis (48.7% vs 28.9%, p=0.013). NFTS patients with contralateral transverse sinus thrombosis had poorer outcomes (excellent outcome 74.4% vs 89.7%, p=0.006). NFTS independently predicted non-excellent outcome (OR 4.37; 95% CI 1.5 to 13; p=0.008).
Conclusions:
NFTS identifies a subset of CVST patients with impaired venous drainage, greater thrombotic extent, increased papilledema and poorer functional recovery. Recognition of NFTS on baseline imaging may assist in risk stratification and tailored monitoring in CVST.
Related Concept Videos
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
01:11Overview of Systemic Veins
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the middle...
01:04Venous Return
What is Venous Return?
Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system as it...
01:30Venous Thrombosis I: Introduction
01:27Assessment of the Cardiovascular System III: Palpation
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...