Kuroda Kiyotaka, Tsutsumi Satoshi, Sugiyama Hiroki, Sugiyama Natsuki, Ueno Hideaki, Ishii Hisato
Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
Radiol Case Rep. 2023 May 18;18(7):2522-2525. doi: 10.1016/j.radcr.2023.04.042. eCollection 2023 Jul.
A 65-year-old man presented with coma. The cranial computed tomography (CT) revealed a massive hematoma in the left cerebral hemisphere, accompanied by intraventricular hemorrhage (IVH) and ventriculomegaly. Contrast examination revealed ectatic superior ophthalmic veins (SOVs). The patient underwent emergent hematoma evacuation. Contrast CT performed on postoperative day (POD) 2 showed a remarkable reduction in the diameters of both SOVs. A second patient, a 53-year-old man, presented with consciousness disturbance and right hemiparesis. CT revealed a large hematoma in the left thalamus, accompanied by massive IVH. Contrast CT demonstrated the bold delineation of the SOVs. The patient underwent endoscopic IVH removal. Contrast CT performed on POD 7 showed a remarkable reduction in the diameters of both SOVs. A third patient, a 72-year-old woman, presented with severe headache. CT revealed diffuse subarachnoid hemorrhage and ventriculomegaly. Contrast CT demonstrated a saccular aneurysm on the internal carotid artery-anterior choroidal artery branching site with the bold delineation of the SOVs. The patient underwent microsurgical clipping. Contrast CT performed on POD 68 showed a remarkable reduction in the diameters of both SOVs. The SOVs may function as an alternative venous drainage pathway in the setting of acute intracranial hypertension due to hemorrhagic stroke.
一名65岁男性出现昏迷症状。头颅计算机断层扫描（CT）显示左侧大脑半球有巨大血肿，伴有脑室内出血（IVH）和脑室扩大。增强检查显示眼上静脉（SOV）扩张。该患者接受了紧急血肿清除术。术后第2天进行的增强CT显示双侧SOV直径显著减小。第二名患者是一名53岁男性，出现意识障碍和右侧偏瘫。CT显示左侧丘脑有一个大血肿，伴有大量IVH。增强CT显示SOV轮廓清晰。该患者接受了内镜下IVH清除术。术后第7天进行的增强CT显示双侧SOV直径显著减小。第三名患者是一名72岁女性，出现严重头痛。CT显示弥漫性蛛网膜下腔出血和脑室扩大。增强CT显示颈内动脉-脉络膜前动脉分支处有一个囊状动脉瘤，SOV轮廓清晰。该患者接受了显微手术夹闭。术后第68天进行的增强CT显示双侧SOV直径显著减小。在出血性中风导致急性颅内高压的情况下，SOV可能作为一种替代的静脉引流途径发挥作用。
