Arauz Antonio, Chavarria-Medina Monica, Patiño-Rodriguez Hernán M, Varela Elizabeth, Serrano Fabiola, Becerril Mayra, Barboza Miguel A
Stroke Clinic, Instituto Nacional de Neurologia y Neurocirugia, Manuel Velasco Suarez, Mexico City, Mexico.
Neuroradiology Department, Instituto Nacional de Neurologia y Neurocirugia, Manuel Velasco Suarez, Mexico City, Mexico.
J Stroke Cerebrovasc Dis. 2018 Feb;27(2):432-437. doi: 10.1016/j.jstrokecerebrovasdis.2017.09.019. Epub 2017 Oct 31.
Hypoplasia of the transverse sinus (TS) is a common anatomical variation. However, the relationship between TS hypoplasia and venous thrombosis has not been studied. We analyzed the hypothesis that TS hypoplasia is a predisposing factor for ipsilateral thrombosis.
We retrospectively evaluated 20 confirmed cases with isolated TS thrombosis and 43 age- and sex-matched controls. TS thrombosis and hypoplasia were diagnosed using both computed tomography and magnetic resonance venography. Hypoplasia was defined as a TS diameter less than 50% of the cross-sectional diameter of the lumen of the distal superior sagittal sinus and by a bony groove ratio less than 1.02. Univariate analysis was performed to evaluate the association between TS hypoplasia and thrombosis.
There were a total of 45 hypoplastic TS: 31 (49%) left hypoplastic TS (12 (60%) cases vs 19 (44%) controls (P = .24), and 14 (22%) right hypoplastic TS (9 (45%) cases vs 5 (12%) controls (P = .003). TS hypoplasia was more frequently found in cases (n = 18, 90.0%) than in controls (n = 22, 51.2%; relative risk 1.7, confidence interval [CI] 95% 1.3-2.4, P = .003). Hypoplastic TS and ipsilateral TS thrombosis showed a significant association (P = .002 for right and P = .008 for left TS hypoplasia) with relative risk of 3.8 (95% CI 1.3-10) for right and 7.5 (95% CI 1.1-48) for left hypoplasia. No significant association was found between hypoplastic TS and functional outcome at 30- or 90-day follow-up.
TS hypoplasia might be a predisposing factor for ipsilateral TS thrombosis, but not for functional outcome.
横窦发育不全是一种常见的解剖变异。然而，横窦发育不全与静脉血栓形成之间的关系尚未得到研究。我们分析了横窦发育不全是同侧血栓形成的一个易感因素这一假说。
我们回顾性评估了20例确诊的孤立性横窦血栓形成病例和43例年龄及性别匹配的对照。横窦血栓形成和发育不全通过计算机断层扫描和磁共振静脉造影进行诊断。发育不全的定义为横窦直径小于上矢状窦远端管腔横截面积直径的50%，且骨沟比小于1.02。进行单因素分析以评估横窦发育不全与血栓形成之间的关联。
共有45个发育不全的横窦：31个（49%）左侧横窦发育不全（12例（60%）病例 vs 19例（44%）对照（P = 0.24）），14个（22%）右侧横窦发育不全（9例（45%）病例 vs 5例（12%）对照（P = 0.003））。病例组（n = 18，90.0%）中横窦发育不全的发生率高于对照组（n = 22，51.2%；相对风险1.7，95%置信区间[CI] 1.3 - 2.4，P = 0.003）。发育不全的横窦与同侧横窦血栓形成存在显著关联（右侧P = 0.002，左侧横窦发育不全P = 0.008），右侧发育不全的相对风险为3.8（95% CI 1.3 - 10），左侧发育不全为7.5（95% CI 1.1 - 48）。在30天或90天随访时，发育不全的横窦与功能结局之间未发现显著关联。
横窦发育不全可能是同侧横窦血栓形成的一个易感因素，但不是功能结局的易感因素。
