Neurological Symptoms Due to Intracranial Venous Congestion in a Hemodialysis Patient With Arteriovenous Shunted Flow

Iguchi, T; Harada, Makoto; Kurihara, Saburo; Ichikawa, Takanori; Satoh, Shunichi; Kobayashi, Mamoru

doi:10.1016/j.ekir.2020.08.007

Cited by 7 publications

(15 citation statements)

References 9 publications

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“…1) CVD often presents as upper limb edema ipsilateral to the hemodialysis shunt, with neurologic symptoms rarely occurring. 1,2) We herein report a case with cerebral venous circulation dysfunction caused by hemodialysis shunt and compare our findings with those published previously.…”

Section: Introductionsupporting

confidence: 69%

Endovascular Treatment of Cerebral Venous Circulation Dysfunction Caused by Hemodialysis Shunt: A Case Report

Ebihara

Sato

Ishikawa

et al. 2022

JNET

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Objective: Central venous disease, defined as ≥50% stenosis or obstruction of central veins, is one of many lifethreatening complications faced by patients on hemodialysis. It often presents as upper limb edema to the arteriovenous (AV) shunt for hemodialysis, although neurological symptoms are rare. We report a case of central venous disease with neurological symptoms associated with endovascular therapy.Case Presentation: A 79-year-old man presented with status epilepticus. His past medical history included rectal carcinoma when he was 69 years old and indication for hemodialysis when he was 79 years old. However, he had no history of neurological disease or epilepsy. On arrival at our facility, CT perfusion revealed venous circulation dysfunction on the left cerebral hemisphere. DSA demonstrated regurgitation from the AV shunt on left upper limb to the cerebral veins and obstruction of the left subclavian vein. Ligation of the causal AV shunt was deemed difficult due to surrounding edema; therefore, endovascular transarterial coil embolization was performed. After completely occluding the AV shunt, patient's condition improved significantly. The patient was discharged 3 days later without neurologic symptoms, with no recurrence of epilepsy was observed to date. Conclusion:Coil embolization of causal AV shunt significantly improved the neurological symptoms of central venous disease.

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Section: Introductionsupporting

confidence: 69%

Endovascular Treatment of Cerebral Venous Circulation Dysfunction Caused by Hemodialysis Shunt: A Case Report

Ebihara

Sato

Ishikawa

et al. 2022

JNET

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“…However, the presence of neurological symptoms is rare and nonspecific [ 5 , 6 ]. In Table 1 [ 1 - 20 ], we summarize the cases of neurological manifestations secondary to CVD reported so far. There is no sex prevalence with a mean age of 55.4 years (standard deviation [SD] ±14.1).…”

Section: Discussionmentioning

confidence: 99%

Central Venous Reflux, a Rare Cause of Neurological Manifestations in Hemodialysis Patients: A Case Report and Literature Review

et al. 2022

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Central venous disease (CVD) is a serious complication in hemodialysis patients. Neurological manifestations are rare. We describe a female with end-stage renal disease with throbbing headache accompanied by paresthesia, weakness, and abnormal posture of her right hand during dialysis sessions. Motor symptoms completely resolved after each dialysis session, although the headaches persisted for several hours. No neurological deficit was evidenced on physical examination. Digital subtraction angiography identified an incomplete thrombosis of the left brachiocephalic vein with retrograde flow in the internal jugular vein, sigmoid sinus, and transverse sinus on the left side. This case illustrates that cerebral venous congestion due to CVD can produce neurological symptoms. Furthermore, we systematically review the literature to identify the characteristics of the cases described so far. This allows clinicians to know the entity and have a high index of suspicion in a hemodialysis patient who develops neurological symptoms.

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“…A case report with cerebral venous hypertension caused by AVG and ipsilateral innominate vein occlusion showed progressive encephalopathy and right occipital infarction ( 2 ). And in other cases of intracranial venous hypertension in a hemodialysis patient with AVG, venous intraparenchymal hemorrhages were reported ( 8 9 ).…”

Section: Discussionmentioning

confidence: 92%

Resolved Cerebral Venous Hypertension after Angioplasty of Central Venous Stenosis in a Hemodialysis Patient: A Case Report

Kang

Park

2022

J Korean Soc Radiol

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Stenosis of the central veins is a common complication in hemodialysis patients. However, cerebral venous hypertension and neurological symptoms caused by central vein stenosis are relatively rare. We present a rare case of cerebral venous hypertension in a 63-year-old male who showed venous reflux into the dural sinuses due to central venous stenosis on time-of-flight MR angiography. After management for central venous stenosis, the venous reflux disappeared.

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Neurological Symptoms Due to Intracranial Venous Congestion in a Hemodialysis Patient With Arteriovenous Shunted Flow

Cited by 7 publications

References 9 publications

Endovascular Treatment of Cerebral Venous Circulation Dysfunction Caused by Hemodialysis Shunt: A Case Report

Endovascular Treatment of Cerebral Venous Circulation Dysfunction Caused by Hemodialysis Shunt: A Case Report

Central Venous Reflux, a Rare Cause of Neurological Manifestations in Hemodialysis Patients: A Case Report and Literature Review

Resolved Cerebral Venous Hypertension after Angioplasty of Central Venous Stenosis in a Hemodialysis Patient: A Case Report

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