Benign Intracranial Hypertension: A Complication of Subclavian Vein Catheterization and Arteriovenous Fistula

Lal, Sunder M.; Twardowski, Zbylut J.; Stone, John Van; Keniston, Dan; Scott, Wendell J.; Berg, G.; Nichols, W. Kirt

doi:10.1016/s0272-6386(86)80037-3

Cited by 30 publications

(22 citation statements)

References 11 publications

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“…In the two previously reported cases of development of intracranial hypertension due to stenosis or occlusion of a central vein in hemodialysis, dilatation of the superfi cial veins was observed in the affected limb [6,7] , and symptoms of intracranial hypertension developed insidiously over a severalweek period. In contrast, dilated superfi cial veins were absent in the present case, and symptoms of intracranial hypertension developed abruptly and progressed rapidly.…”

Section: Discussionmentioning

confidence: 99%

“…If the draining vein of a functioning shunt is obstructed, extreme venous hypertension can develop and result in pain, incapacitating swelling, and venous stasis ulcers of the arm, chest, neck and face on the ipsilateral side [4,5] . A few reports have suggested that intracranial venous hypertension may also occur in the context of peripheral venous obstruction [6,7] . We report a case of acute intracranial hypertension due to occlusion of the brachiocephalic vein in a patient undergoing hemodialysis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Nishimoto

Ogasawara²,

Miura³

et al. 2005

Cerebrovasc Dis

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Nishimoto

Ogasawara²,

Miura³

et al. 2005

Cerebrovasc Dis

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“…We believe this is the first case report of parenchymal brain hemorrhage resulting from cerebral venous hypertension and increased intracranial pressure due to a hypoplastic transverse sinus [8][9][10].…”

Section: Discussionmentioning

confidence: 77%

Cerebral hemorrhage due to internal jugular vein stenosis in a hemodialysis patient

et al. 2011

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A 53 year old female with ESRD on hemodialysis presented with headache, vomiting, and lethargy that had started 2 h prior to presentation. Magnetic resonance imaging revealed parenchymal hemorrhage in the temporal, occipital, and cerebellar white matter. Magnetic resonance venography disclosed hypoplastic transverse sinus. On cerebral angiogram there was no evidence of cerebral aneurysm, vasculitis or vascular malformation. Angiogram demonstrated a high-grade stenosis was present in the left internal jugular vein (IJV) just below the anastomosis of the graft. There was retrograde high flow in the left IJV above the anastomosis of the graft, which fills a small left transverse venous sinus. There was also filling of the multiple abnormally enlarged leptomeningeal veins over the surface of the left cerebral and left cerebellar hemispheres. Retrograde blood flow was due to IJV stenosis which led to cerebral venous hypertension and intraparenchymal brain hemorrhage. She then underwent occlusion of her left brachiojugular dialysis graft. Thereafter, her mental status markedly improved and her headache resolved. Since IJV stenosis and hypoplastic transverse sinuses are not rare, patients with jugular grafts should probably be closely watched for symptoms of increased intracranial pressure. As awareness of vein preservation in CKD patients grows, the prevalence of CVS would probably decline in future.

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“…There are only a few reports of intracranial hypertension due to impaired cerebral drainage in patients with renal failure [25][26][27][28][29][30]. These cases are summarized in Table 1 and involve only adult hemodialysis patients after multiple vascular accesses with "worn out" central veins.…”

Section: Discussionmentioning

confidence: 99%

“…Brain MRI and MRV are indicated for evaluation of the abnormal intracranial circulation and planning of the appropriate intervention to prevent visual loss and a catastrophic neurological outcome. Lal et al, [25] Molina et al, [26] Varelas et al, [27] Hartman et al, [28] Cuadra et al, [29] Gender …”

Section: Discussionmentioning

confidence: 99%

Neurologic and ophthalmologic complications of vascular access in a hemodialysis patient

Cleper¹,

Goldenberg-Cohen²,

Kornreich³

et al. 2007

Pediatr Nephrol

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Patients on long-term hemodialysis undergo multiple interventions, including insertion of central catheters and arteriovenous anastomoses for creation of vascular access. The need for high-flow vessels to maintain hemodialysis efficiency leads to wear on the central veins and consequent stenosis and occlusion. In addition to local signs of impaired venous drainage, abnormal venous flow patterns involving the upper chest, face, and central nervous system might develop. We describe the first pediatric case of devastating intracranial hypertension presenting with visual loss in the eye contralateral to a high-flow vascular access in a patient on long-term hemodialysis. The literature on this rare complication of hemodialysis is reviewed.

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Benign Intracranial Hypertension: A Complication of Subclavian Vein Catheterization and Arteriovenous Fistula

Cited by 30 publications

References 11 publications

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

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

Cerebral hemorrhage due to internal jugular vein stenosis in a hemodialysis patient

Neurologic and ophthalmologic complications of vascular access in a hemodialysis patient

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