A school of red herring

MacIntosh, Peter W.; Jain, Sachin; Moss, Heather E.; Volpe, Nicholas J.; Alaraj, Ali

doi:10.1016/j.survophthal.2014.01.010

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…2–4,13 We demonstrate quantitative improvement in cerebral venous outflow following surgical intervention and further improvement with additional medical management. In addition, we demonstrate a narrowing of the gap between measured arterial inflows and venous outflows following treatment, similar to Q-MRV findings in dural arterial venous fistula associated IH 17 and idiopathic IH. 1 These Q-MRV results provide an objective measure of short and long term patient outcomes and could be a potential method with which to track progress in patient recovery over extended periods of time.…”

Section: Discussionsupporting

confidence: 81%

Improvement in venous outflow following superior sagittal sinus decompression after a gunshot wound to the head: case report

Birk¹,

Tobin²,

Moss

et al. 2015

JNS

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The most commonly described indications for surgical management of closed depressed skull fractures are hematoma evacuation and repair of extensive cosmetic deformity. Venous sinus injury, which occurs in a subset of depressed skull fractures is not typically listed as an indication for surgical treatment due to the potential for major venous hemorrhage associated with operation near these structures. However, if patients exhibit signs and symptoms of intracranial hypertension and radiographic findings demonstrate sinus compromise, surgical elevation of the depressed skull fragments is indicated. The authors present the case of a 25-year-old woman with a depressed skull fracture secondary to a gunshot wound with symptomatic compromise in venous outflow of the posterior one-third of the superior sagittal sinus. The patient was treated with surgical decompression via bilateral craniectomy along with intracranial pressure lowering medical therapy and had almost full resolution of her presenting symptoms with documented improvement in flow through the superior sagittal sinus. While the use of surgical treatment for these types of injuries is highly debated we demonstrate here that safe, effective surgical management of these patients is possible and that surgical decompression should always be considered in the case of symptomatic venous sinus flow obstruction.

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Section: Discussionsupporting

confidence: 81%

Improvement in venous outflow following superior sagittal sinus decompression after a gunshot wound to the head: case report

Birk¹,

Tobin²,

Moss

et al. 2015

JNS

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“…10, 13 Venous applications of qMRA (qMRV), however, have been less studied. With the exception of a case report featuring one of our patients 14 , our paper is the first to use qMRV to assess venous sinus stenosis and stenting.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Magnetic Resonance Venography is Correlated With Intravenous Pressures Before and After Venous Sinus Stenting

et al. 2015

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BACKGROUND Endovascular stenting is an effective treatment for patients with clinically significant cerebral venous sinus stenosis. Traditionally, stenting is indicated in patients with elevated intravenous pressures on conventional venography; however, noninvasive monitoring is more desirable. Quantitative magnetic resonance angiography is an imaging modality that allows blood flow assessment noninvasively. Established in the arterial system, applications to the venous sinuses have been limited to date. OBJECTIVE In this study, we examined quantitative magnetic resonance venography (qMRV) flow in patients before and after venous stenting and correlated these results with intravenous pressure measurements and clinical outcomes. METHODS Five patients with intracranial hypertension (IH) secondary to venous sinus stenosis underwent cerebral venous stenting between 2009 and 2013 at a single institution. Preoperatively venous sinus flow was determined using qMRV, and intravenous pressure measured during venography. After stenting, intravenous pressure, qMRV flow, and clinical outcomes were assessed and compared. RESULTS A mean prestenotic intravenous pressure of 45.2 mmHg was recorded before stenting which decreased to 27.4mmHg afterwards (Wilcoxon signed rank test P=.04). Total jugular outflow on qMRV increased by 260.2 ml/min. Analysis of the change in intravenous pressure and qMRV flow identified a linear relationship (Pearson's correlation r= .926). All patients displayed clinical improvement, including vision. CONCLUSION Venous outflow by qMRV increases after endovascular stenting and correlates with significantly improved intravenous pressures. These findings establish qMRV as a useful adjunct to measure venous flow after stenting, and as a potential tool in the selection and postoperative surveillance of the cerebral venous sinus stenosis patient.

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Monitoring Treatment Effectiveness in Intracranial Arteriovenous Shunt Lesions: Emerging Role of Quantitative Magnetic Resonance Venography for Intracranial Arteriovenous Shunts

et al. 2020

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A school of red herring

Cited by 3 publications

References 23 publications

Improvement in venous outflow following superior sagittal sinus decompression after a gunshot wound to the head: case report

Improvement in venous outflow following superior sagittal sinus decompression after a gunshot wound to the head: case report

Quantitative Magnetic Resonance Venography is Correlated With Intravenous Pressures Before and After Venous Sinus Stenting

Monitoring Treatment Effectiveness in Intracranial Arteriovenous Shunt Lesions: Emerging Role of Quantitative Magnetic Resonance Venography for Intracranial Arteriovenous Shunts

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