Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.
J Thromb Thrombolysis. 2019 Jul;48(1):61-67. doi: 10.1007/s11239-019-01820-1.
Internal jugular vein (IJV) stenosis and cerebral venous sinus (CVS) stenosis belong to cerebral venous outflow insufficiency. This study aimed to analyze the similarities and differences between IJV stenosis and CVS stenosis. Patients with either IJV stenosis or CVS stenosis confirmed by contrast-enhanced magnetic resonance venography between October 2017 and July 2018 were enrolled in this retrospective study. The similarities and differences between IJV stenosis and CVS stenosis on the aspects of clinical and imaging features were compared. A total of 82 eligible patients entered into the final analysis. The similarities of the two subsets of cerebral venous outflow insufficiency mainly included headache, head noises or tinnitus, visual disorders, and sleeping disorders, as well as cloud-like white matter hyperintensity in T2WI and FLAIR sequences of MRI. However, there were differences in between, the ratio of patients with higher intracranial pressure (ICP) was common in CVS stenosis (p < 0.001). Namely, higher ratios of papilledema (p = 0.001) and visual damage (p = 0.029), as well as poor Frisen papilledema grade scores were more commonly observed in CVS stenosis (p = 0.004), while abnormal collateral-vessels appeared more frequently in IJV stenosis (100.00%) than CVS stenosis (28.57%). Continuous head noises, tinnitus and cloud-like white matter hyperintensity in MRI are the features of both IJV stenosis and CVS stenosis. Whereas, severe headache, visual damage, papilledema, and intracranial hypertension (IH) were more common in CVS stenosis, and the appearance of collateral-vessels is a key feature of IJV stenosis.
颈内静脉（IJV）狭窄和脑静脉窦（CVS）狭窄属于脑静脉流出不足。本研究旨在分析 IJV 狭窄和 CVS 狭窄之间的异同。回顾性分析 2017 年 10 月至 2018 年 7 月间经增强磁共振静脉造影（MRV）证实存在 IJV 狭窄或 CVS 狭窄的患者。比较了 IJV 狭窄和 CVS 狭窄在临床和影像学特征方面的异同。共 82 例符合条件的患者纳入最终分析。两种脑静脉流出不足的相似之处主要包括头痛、头鸣或耳鸣、视力障碍和睡眠障碍，以及 MRI 的 T2WI 和 FLAIR 序列上云状的脑白质高信号。然而，两者之间也存在差异，CVS 狭窄患者颅内压（ICP）升高的比例较高（p<0.001）。即 CVS 狭窄患者更常见视盘水肿（p=0.001）和视力损害（p=0.029），Frisen 视盘水肿分级评分较差（p=0.004），而 IJV 狭窄患者更常出现异常侧支血管（100.00%比 CVS 狭窄 28.57%）。持续的头部噪音、耳鸣和 MRI 上的云状脑白质高信号是 IJV 狭窄和 CVS 狭窄的共同特征。然而，CVS 狭窄更常见严重头痛、视力损害、视盘水肿和颅内高压（IH），而侧支血管的出现是 IJV 狭窄的一个关键特征。
