Neuroimaging clinics of North America
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Sinus thrombosis in children is increasingly recognized; however, the diagnosis is still frequently missed. Children may have an increased incidence of this disorder compared with adults, and neonates are at greatly increased risk compared with older children. Childhood CSVT carries significant long-term sequelae that include death or neurologic deficits in nearly 50% of cases. ⋯ Among the most significant current and future developments in childhood CSVT is the evolution of accurate, noninvasive and economical neuroimaging techniques. The latter techniques have the potential to increase the detection rate of childhood CSVT, improve our understanding of the pathophysiology and define important subgroups of patients who best respond to treatment. An international interest in childhood CSVT is developing and, in the next decade, will enable the necessary multi-national clinical trials to provide evidence-based treatments and decrease the adverse outcomes.
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Neuroimaging Clin. N. Am. · Feb 2003
ReviewHydrovenous disorders in pediatric intracranial arteriovenous fistula.
High-flow AVFs are a challenging problem in the pediatric age group. Venous occlusive changes develop as part of the dynamic response to these fistulas. The development of adequate venous collateral flow circumvents the destructive sequelae of longstanding venous hypertension. ⋯ Venous hypertension interferes with CSF resorption, resulting in increased brain water. Ventriculomegaly and tonsillar prolapse commonly develop and are reversible if therapeutic intervention is done in a timely fashion. If left untreated, chronic venous ischemic changes develop, which result in delay in important developmental milestones.
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Neuroimaging Clin. N. Am. · Feb 2003
ReviewRadiologic findings and clinical significance of venous compartment of brain arteriovenous shunts.
The venous compartment of brain AVS is closely related to the development of various clinical consequences, including hemorrhage, seizure, and neurologic deficit. Therefore, understanding the venous etiology of the clinical symptoms and the imaging characteristics of partial or complete venous outlet thrombosis is critical for the proper management of patients with brain AVSs.
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Neuroimaging Clin. N. Am. · Feb 2003
ReviewVenous congestive encephalopathy related to cranial dural arteriovenous fistulas.
Cranial DAVFs present with a wide spectrum of clinical findings from pulsatile tinnitus alone to intracranial hemorrhage and NHND. The neurologic sequelae are a consequence of venous hypertension and venous congestion. DAVFs with CVR can present with or develop a VCE that can be recognized on MR imaging as a diffuse T2 hyperintensity in the deep white matter of the cerebral or cerebellar hemispheres. ⋯ The telltale sign on MR imaging is the plethora of prominent pial vessels on the surface of the brain that are the engorged cortical veins participating in the cortical venous reflux. Selective angiography is critical for the accurate assessment of the CVR. DAVFs with CVR require prompt treatment, either endovascular alone or a combination of endovascular treatment and surgery.