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Michael G. Hennerici - One of the best experts on this subject based on the ideXlab platform.
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echocontrast enhanced transcranial color coded sonography for the diagnosis of Transverse Sinus venous thrombosis
Stroke, 1997Co-Authors: S. Ries, W. Steinke, K. W. Neff, Michael G. HennericiAbstract:Background and Purpose Early diagnosis of cerebral Transverse Sinus venous thrombosis (TSVT) is difficult because of nonspecific and variable clinical presentations. Therefore, we evaluated the diagnostic value of transcranial color-coded duplex sonography (TCCS) after administration of an echocontrast-enhancing agent (cTCCS) in clinically suspected TSVT. Methods We examined 14 patients (6 men, 8 women; mean age, 48 years; range, 18 to 70 years) with signs and symptoms suggestive of cerebral TSVT. Color-coded signals from the contralateral Transverse Sinus were displayed transtemporally before and after injections of an echocontrast agent by TCCS. Sonographic findings were correlated with MRI and MR venography (MRV). Results Before echocontrast enhancement, TCCS displayed color Doppler signals in 7 of 28 Transverse Sinus. Echocontrast TCCS obtained sufficient color signals in 27 of 28 Transverse Sinus. Thus, diagnostic confidence was achieved in all but 1 patient. In 13 patients, cTCCS identified 3 cases with symmetrical blood flow in the Transverse Sinus, which was confirmed by MRV. Accordingly, asymmetry of venous blood flow was correctly assessed by cTCCS in the other 10 patients. In 6 of these 10 patients, cTCCS demonstrated residual color flow signals, which on MRI/MRV corresponded to partial TSVT (4 cases) and to hypoplasia (1 case) of the Transverse Sinus. One case of complete thrombotic occlusion of the Transverse Sinus was missed by cTCCS because of color Doppler signals originating from an adjacent dural fistula. Echocontrast TCCS diagnosis of occlusion of a Transverse Sinus was confirmed by MRI/MRV in all cases (aplasia of Transverse Sinus, n=1; complete TSVT, n=3). Systolic peak flow velocities were significantly decreased in hypoplastic or partially occluded Transverse Sinus (9.4±4.0 cm/s) and significantly increased contralaterally (28.4±6.5 cm/s) with respect to patients with symmetrical appearance of the Transverse Sinus (17.5±1.9 cm/s) ( P <.05). Conclusions TCCS examination of the cerebral venous system is difficult without contrast media application and almost useless for the study of TSVT. However, cTCCS is of practical value in the initial workup of patients with clinically suspected TSVT and may provide further insight for follow-up studies in view of monitoring the recanalization.
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Echocontrast-Enhanced Transcranial Color-Coded Sonography for the Diagnosis of Transverse Sinus Venous Thrombosis
Stroke, 1997Co-Authors: S. Ries, W. Steinke, K. W. Neff, Michael G. HennericiAbstract:Background and Purpose Early diagnosis of cerebral Transverse Sinus venous thrombosis (TSVT) is difficult because of nonspecific and variable clinical presentations. Therefore, we evaluated the diagnostic value of transcranial color-coded duplex sonography (TCCS) after administration of an echocontrast-enhancing agent (cTCCS) in clinically suspected TSVT. Methods We examined 14 patients (6 men, 8 women; mean age, 48 years; range, 18 to 70 years) with signs and symptoms suggestive of cerebral TSVT. Color-coded signals from the contralateral Transverse Sinus were displayed transtemporally before and after injections of an echocontrast agent by TCCS. Sonographic findings were correlated with MRI and MR venography (MRV). Results Before echocontrast enhancement, TCCS displayed color Doppler signals in 7 of 28 Transverse Sinus. Echocontrast TCCS obtained sufficient color signals in 27 of 28 Transverse Sinus. Thus, diagnostic confidence was achieved in all but 1 patient. In 13 patients, cTCCS identified 3 cases with symmetrical blood flow in the Transverse Sinus, which was confirmed by MRV. Accordingly, asymmetry of venous blood flow was correctly assessed by cTCCS in the other 10 patients. In 6 of these 10 patients, cTCCS demonstrated residual color flow signals, which on MRI/MRV corresponded to partial TSVT (4 cases) and to hypoplasia (1 case) of the Transverse Sinus. One case of complete thrombotic occlusion of the Transverse Sinus was missed by cTCCS because of color Doppler signals originating from an adjacent dural fistula. Echocontrast TCCS diagnosis of occlusion of a Transverse Sinus was confirmed by MRI/MRV in all cases (aplasia of Transverse Sinus, n=1; complete TSVT, n=3). Systolic peak flow velocities were significantly decreased in hypoplastic or partially occluded Transverse Sinus (9.4±4.0 cm/s) and significantly increased contralaterally (28.4±6.5 cm/s) with respect to patients with symmetrical appearance of the Transverse Sinus (17.5±1.9 cm/s) ( P
J J Merland - One of the best experts on this subject based on the ideXlab platform.
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percutaneous transvenous embolization through the thrombosed Sinus in Transverse Sinus dural fistula
American Journal of Neuroradiology, 1993Co-Authors: Y P Gobin, Emmanuel Houdart, Andre Rogopoulos, A Casasco, A L Bailly, J J MerlandAbstract:Each of two patients presented with a dural arteriovenous fistula involving the Transverse Sinus. The Sinus was thrombosed proximal and distal to the dural arteriovenous fistula with the venous drainage being retrograde through cortical veins. An ipsilateral percutaneous transjugular approach was used in both cases and allowed recanalization of the thrombosed Sinus and embolization of the dural arteriovenous fistula with coils. Complete cure was achieved in one patient and 95% reduction in arteriovenous shunting including elimination of the cortical venous reflux in the other. This technique avoided surgical exposure of the Sinus.
S. Ries - One of the best experts on this subject based on the ideXlab platform.
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echocontrast enhanced transcranial color coded sonography for the diagnosis of Transverse Sinus venous thrombosis
Stroke, 1997Co-Authors: S. Ries, W. Steinke, K. W. Neff, Michael G. HennericiAbstract:Background and Purpose Early diagnosis of cerebral Transverse Sinus venous thrombosis (TSVT) is difficult because of nonspecific and variable clinical presentations. Therefore, we evaluated the diagnostic value of transcranial color-coded duplex sonography (TCCS) after administration of an echocontrast-enhancing agent (cTCCS) in clinically suspected TSVT. Methods We examined 14 patients (6 men, 8 women; mean age, 48 years; range, 18 to 70 years) with signs and symptoms suggestive of cerebral TSVT. Color-coded signals from the contralateral Transverse Sinus were displayed transtemporally before and after injections of an echocontrast agent by TCCS. Sonographic findings were correlated with MRI and MR venography (MRV). Results Before echocontrast enhancement, TCCS displayed color Doppler signals in 7 of 28 Transverse Sinus. Echocontrast TCCS obtained sufficient color signals in 27 of 28 Transverse Sinus. Thus, diagnostic confidence was achieved in all but 1 patient. In 13 patients, cTCCS identified 3 cases with symmetrical blood flow in the Transverse Sinus, which was confirmed by MRV. Accordingly, asymmetry of venous blood flow was correctly assessed by cTCCS in the other 10 patients. In 6 of these 10 patients, cTCCS demonstrated residual color flow signals, which on MRI/MRV corresponded to partial TSVT (4 cases) and to hypoplasia (1 case) of the Transverse Sinus. One case of complete thrombotic occlusion of the Transverse Sinus was missed by cTCCS because of color Doppler signals originating from an adjacent dural fistula. Echocontrast TCCS diagnosis of occlusion of a Transverse Sinus was confirmed by MRI/MRV in all cases (aplasia of Transverse Sinus, n=1; complete TSVT, n=3). Systolic peak flow velocities were significantly decreased in hypoplastic or partially occluded Transverse Sinus (9.4±4.0 cm/s) and significantly increased contralaterally (28.4±6.5 cm/s) with respect to patients with symmetrical appearance of the Transverse Sinus (17.5±1.9 cm/s) ( P <.05). Conclusions TCCS examination of the cerebral venous system is difficult without contrast media application and almost useless for the study of TSVT. However, cTCCS is of practical value in the initial workup of patients with clinically suspected TSVT and may provide further insight for follow-up studies in view of monitoring the recanalization.
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Echocontrast-Enhanced Transcranial Color-Coded Sonography for the Diagnosis of Transverse Sinus Venous Thrombosis
Stroke, 1997Co-Authors: S. Ries, W. Steinke, K. W. Neff, Michael G. HennericiAbstract:Background and Purpose Early diagnosis of cerebral Transverse Sinus venous thrombosis (TSVT) is difficult because of nonspecific and variable clinical presentations. Therefore, we evaluated the diagnostic value of transcranial color-coded duplex sonography (TCCS) after administration of an echocontrast-enhancing agent (cTCCS) in clinically suspected TSVT. Methods We examined 14 patients (6 men, 8 women; mean age, 48 years; range, 18 to 70 years) with signs and symptoms suggestive of cerebral TSVT. Color-coded signals from the contralateral Transverse Sinus were displayed transtemporally before and after injections of an echocontrast agent by TCCS. Sonographic findings were correlated with MRI and MR venography (MRV). Results Before echocontrast enhancement, TCCS displayed color Doppler signals in 7 of 28 Transverse Sinus. Echocontrast TCCS obtained sufficient color signals in 27 of 28 Transverse Sinus. Thus, diagnostic confidence was achieved in all but 1 patient. In 13 patients, cTCCS identified 3 cases with symmetrical blood flow in the Transverse Sinus, which was confirmed by MRV. Accordingly, asymmetry of venous blood flow was correctly assessed by cTCCS in the other 10 patients. In 6 of these 10 patients, cTCCS demonstrated residual color flow signals, which on MRI/MRV corresponded to partial TSVT (4 cases) and to hypoplasia (1 case) of the Transverse Sinus. One case of complete thrombotic occlusion of the Transverse Sinus was missed by cTCCS because of color Doppler signals originating from an adjacent dural fistula. Echocontrast TCCS diagnosis of occlusion of a Transverse Sinus was confirmed by MRI/MRV in all cases (aplasia of Transverse Sinus, n=1; complete TSVT, n=3). Systolic peak flow velocities were significantly decreased in hypoplastic or partially occluded Transverse Sinus (9.4±4.0 cm/s) and significantly increased contralaterally (28.4±6.5 cm/s) with respect to patients with symmetrical appearance of the Transverse Sinus (17.5±1.9 cm/s) ( P
Y P Gobin - One of the best experts on this subject based on the ideXlab platform.
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percutaneous transvenous embolization through the thrombosed Sinus in Transverse Sinus dural fistula
American Journal of Neuroradiology, 1993Co-Authors: Y P Gobin, Emmanuel Houdart, Andre Rogopoulos, A Casasco, A L Bailly, J J MerlandAbstract:Each of two patients presented with a dural arteriovenous fistula involving the Transverse Sinus. The Sinus was thrombosed proximal and distal to the dural arteriovenous fistula with the venous drainage being retrograde through cortical veins. An ipsilateral percutaneous transjugular approach was used in both cases and allowed recanalization of the thrombosed Sinus and embolization of the dural arteriovenous fistula with coils. Complete cure was achieved in one patient and 95% reduction in arteriovenous shunting including elimination of the cortical venous reflux in the other. This technique avoided surgical exposure of the Sinus.
Rebekah M Ahmed - One of the best experts on this subject based on the ideXlab platform.
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Venous hypertension as the cause of intracranial hypertension in patients with Transverse Sinus dural arteriovenous fistula.
Journal of Neuro-Ophthalmology, 2013Co-Authors: Rebekah M Ahmed, Geoffrey Parker, Mark E Wilkinson, Bryan Khoury, G. Michael HalmagyiAbstract:We describe 2 patients with Transverse Sinus dural arteriovenous fistulas (DAVFs) who presented with headache and papilledema due to intracranial hypertension. It has been proposed, but never proven, that venous hypertension causes the intracranial hypertension in DAVF. The data from our patients support this hypothesis. An additional factor leading to intracranial hypertension could be stenosis of the fellow Transverse Sinus.
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Transverse Sinus stenting for idiopathic intracranial hypertension a review of 52 patients and of model predictions
American Journal of Neuroradiology, 2011Co-Authors: Rebekah M Ahmed, Geoffrey Parker, Mark E Wilkinson, Matthew J Thurtell, J Macdonald, Peter Mccluskey, R Allan, Victoria G Dunne, M Hanlon, Brian OwlerAbstract:BACKGROUND AND PURPOSE: Transverse Sinus stenosis is common in patients with IIH. While the role of Transverse Sinus stenosis in IIH pathogenesis remains controversial, modeling studies suggest that stent placement within a Transverse Sinus stenosis with a significant pressure gradient should decrease cerebral venous pressure, improve CSF resorption in the venous system, and thereby reduce intracranial (CSF) pressure, improving the symptoms of IIH and reducing papilledema. We aimed to determine if IIH could be reliably treated by stent placement in Transverse Sinus stenosis. MATERIALS AND METHODS: We reviewed the clinical, venographic, and intracranial pressure data before and after stent placement in Transverse Sinus stenosis in 52 of our own patients with IIH unresponsive to maximum acceptable medical treatment, treated since 2001 and followed between 2 months and 9 years. RESULTS: Before stent placement, the mean superior sagittal Sinus pressure was 34 mm Hg (462 mm H20) with a mean Transverse Sinus stenosis gradient of 20 mm Hg. The mean lumbar CSF pressure before stent placement was 322 mm H2O. In all 52 patients, stent placement immediately eliminated the TSS pressure gradient, rapidly improved IIH symptoms, and abolished papilledema. In 6 patients, symptom relapse (headache) was associated with increased venous pressure and recurrent stenosis adjacent to the previous stent. In these cases, placement of another stent again removed the Transverse Sinus stenosis pressure gradient and improved symptoms. Of the 52 patients, 49 have been cured of all IIH symptoms. CONCLUSIONS: These findings indicate a role for Transverse Sinus stent placement in the management of selected patients with IIH.
