Acute Intracranial Hypertension due to Occlusion of the Brachiocephalic Vein in a Patient Undergoing Hemodialysis

Cerebral Infarction due to Central Vein Occlusion in a Hemodialysis Patient

“…Rarely, neurological signs and symptoms secondary to intracranial venous congestion may be a manifestation of central vein occlusion . Brachiocephalic vein stenosis or occlusion in particular has been shown to be associated with flow reversal within the left IJV, facial edema, and rarely cerebral venous hypertension …”

“…Signs and symptoms of VCE are nonspecific and may be reversible if the underlying cause is treated early . A delay in diagnosis, however, can lead to parenchymal infarction or hemorrhage .…”

“…Cases such as ours are not commonly seen given that, in the early stages of central venous occlusion, collateral blood flow into superficial and deep veins of the chest and neck may develop prior to venous reflux into intracranial veins. Rapid development of central venous stenosis or occlusion, however, may not allow for the development of collateral venous channels, which could result in intracranial shunting and acute neurological manifestations . It is also postulated that cerebral venous reflux can be tolerated if alterative intracranial routes of drainage are present via the dural sinuses into the contralateral IJV and/or if cerebral venous hypertension is mild, although these ideas have not been proven …”

Hemodialysis graft-induced intracranial hypertension

“…2,[5][6][7][8] Furthermore, intracranial hypertension has not been reported in association with HeRO grafts, despite increasing venous flow specifically in patients with central venous stenosis, suggesting the contribution of additional factors to the pathogenesis of hemodialysis graft-induced intracranial hypertension. Although usually treated by graft ligation or venoplasty with or without a stent, CSF shunting without graft ligation is also a treatment option in patients with isolated intracranial hypertension whose venous anatomy is seriously compromised.…”

Venous Cerebral Infarction in a Patient With Peripheral Hemodialysis Shunt and Occlusion of the Left Brachiocephalic Vein

“…Ó 2011 by National Stroke Association Central venous occlusion rarely develops in hemodialysis patients without a central venous catheter. [1][2][3][4] Occlusion of the draining central vein of the arteriovenous shunt induces extreme venous hypertension and in rare cases causes intracranial venous congestion. 1,2,5 We report a patient with venous cerebral infarction resulting from a peripheral hemodialysis shunt and occlusion of the left brachiocephalic vein.…”