Department of Neurointerventional Surgery, Baptist Cardiac and Vascular Institute, Miami, FL 33156, USA.
J Neurointerv Surg. 2013 Sep 1;5(5):e37. doi: 10.1136/neurintsurg-2012-010355. Epub 2012 Aug 17.
The clinical presentation and imaging of venous congestive encephalopathy (VCE) can mimic several neurological conditions, making the diagnosis challenging. We report a patient with end stage renal disease on dialysis who presented with a right occipital infarction. The patient developed progressive encephalopathy and increased intracranial pressure. Extensive imaging, electroencephalography and serum analysis did not explain the cause of his infarction and progressive neurological deterioration. Finally, cerebral angiography and venography demonstrated severe generalized VCE due to arterial shunting from a right upper extremity arteriovenous graft (AVG) and an occluded right innominate venous trunk. The right arm shunt resulted in severe cerebral venous hypertension due to ipsilateral occlusion of the innominate venous trunk. After the AVG was repaired, the cerebral venous hypertension resolved and the patient returned to baseline.
静脉充血性脑病（VCE）的临床表现和影像学表现可模仿多种神经系统疾病，导致诊断具有挑战性。我们报告了一例透析终末期肾病患者，其表现为右侧枕叶梗死。该患者出现进行性脑病和颅内压升高。广泛的影像学、脑电图和血清分析均未能解释其梗死和进行性神经功能恶化的原因。最终，脑血管造影和静脉造影显示由于右侧上肢动静脉移植物（AVG）和闭塞的右无名静脉干的动脉分流导致严重的全身性 VCE。由于无名静脉干的同侧闭塞，右侧臂分流导致严重的脑静脉高压。修复 AVG 后，脑静脉高压得到缓解，患者恢复到基线水平。
