Mirza Mohammed H, Schwertner Adam, Kohlbrenner Ryan, Dowd Christopher F, Narsinh Kazim H
Department of Radiology, University of Illinois College of Medicine, Peoria, IL, United States.
Department of Radiology, University of Colorado Denver School of Medicine, Denver, CO, United States.
Interdiscip Neurosurg. 2021 Jun;24. doi: 10.1016/j.inat.2020.101081. Epub 2021 Jan 4.
Central venous stenosis in hemodialysis patients rarely causes venous hypertension and intracranial hemorrhage. A 54 year-old male with right arm arteriovenous fistula was transferred to our institution in a comatose state following right parietal venous infarction. Fistulography showed right brachiocephalic vein (BCV) occlusion with reflux into the right transverse sinus and obstruction of left internal jugular vein outflow due to the styloid process. Balloon venoplasty of the right BCV occlusion failed to improve the patient's status because of the delayed diagnosis. Headaches and neurologic symptoms in hemodialysis patients can herald intracranial hypertension due to central venous occlusion and needs prompt assessment with fistulography.
血液透析患者的中心静脉狭窄很少导致静脉高压和颅内出血。一名54岁男性，右上肢动静脉内瘘，在右顶叶静脉梗死昏迷后被转入我院。瘘管造影显示右头臂静脉（BCV）闭塞，造影剂反流至右横窦，且由于茎突导致左颈内静脉流出道梗阻。由于诊断延迟，对右BCV闭塞进行球囊血管成形术未能改善患者状况。血液透析患者的头痛和神经症状可能预示着由于中心静脉闭塞导致的颅内高压，需要通过瘘管造影进行及时评估。
