ORIGINAL ARTICLE   

Acta Phlebologica 2021 August;22(2):45-50

DOI: 10.23736/S1593-232X.21.00484-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Clinical and neuroimaging signs of cerebral venous thrombosis in patients with hypertensive dyscirculatory encephalopathy

Lyudmila A. BELOVA ¹ ✉, Victor V. MASHIN ¹, Natalia V. BELOVA ², Michail. Y. MOISEEV ¹, Anastasiya I. EPISHEVA ¹, Pier Luigi ANTIGNANI ³, Angelo SCUDERI ⁴

¹ Medical Faculty, Institute of Medicine, Ecology and Physical Education, Ulyanovsk State University, Ulyanovsk, Russia; ² The Research Center of Neurology, Moscow, Russia; ³ Vascular Center, Nuova Villa Claudia Clinic, Rome, Italy; ⁴ University Hospital Santa Lucinda, Sorocaba, Brazil

BACKGROUND: The aim of the work was to study the clinical and neuroimaging signs of cerebral venous thrombosis in patients with hypertensive dyscirculatory encephalopathy (HDE).
METHODS: We examined 132 patients with HDE. The patients were divided into groups depending on the stage of the disease and depending on the presence or absence of constitutional venous insufficiency (CVI). All patients underwent magnetic resonance imaging (MRI) of the brain and magnetic resonance venography (MRV) on a device with a field strength of 1.5 T.
RESULTS: According to the MRI data, 23 patients with HDE (17.4%) had thrombosis of the transverse and sigmoid sinuses of the dura mater in the chronic stage: 13 patients (56.5%) had thrombosis of the left transverse sinus and 10 patients (43.5%) had thrombosis of the right transverse sinus. At the same time, at stage I HDE, venous thrombosis was detected in six patients (16.2%), at stage II in nine people (17.6%), at stage III HDE in eight patients (18.2%). Thrombosis of the transverse and sigmoid sinuses of the dura mater was detected more frequently in patients with GDE with CVI (24.7%) compared to patients without CVI (8.5%). Thrombosis of intracranial venous sinuses in the acute stage was not detected. The correlation between the average strength of venous sinus thrombosis and “venous” complaints and neurological symptoms of cerebral venous dyscirculation was determined.
CONCLUSIONS: Thrombosis of venous sinuses of the dura mater in the chronic stage is a neuroimaging correlate of CVI in patients with HDE. Clinical manifestations of dura mater sinus thrombosis in patients with HDE do not correspond to the classical description of cerebral venous thrombosis. MRI is the most important non-invasive neuroimaging method for the diagnosis of cerebral venous disorders in patients with HDE.

KEY WORDS: Intracranial thrombosis; Venous thrombosis; Hypertensive encephalopathy; Venous insufficiency; Magnetic resonance imaging; Plebography