Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2022; 19 (3): 193-286 ➤ К проблеме диагностики начальных проявлений недостаточности венозного церебрального кровообращения

On the problem of diagnosing the initial manifestations of insufficiency of venous cerebral circulation

Authors: Semenov S.E., Shatokhina M.G., Bondarchuk D.V., Moldavskaya I.V.

Company:
1 Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
2 Clinical Hospital of St. Luke, St. Petersburg, Russian Federation
3 Scientific and Practical Clinical Center for Diagnostics and Telemedicine, Moscow, Russian Federation
4 Kemerovo Regional Clinical Cardiology Dispensary named after academician L.S. Barbarash, Kemerovo, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2022-19-3-266-279

UDC: 616.831-005:616.14]-089

Link: Clinical Physiology of Blood Circulaiton. 2022; 3 (19): 266-279

Quote as: Semenov S.E., Shatokhina M.G., Bondarchuk D.V., Moldavskaya I.V. On the problem of diagnosing the initial manifestations of insufficiency of venous cerebral circulation. Clinical Physiology of Circulation. 2022; 19 (3): 266–79 (in Russ.). DOI: 10.24022/1814-6910-2022-19-3-266-279

Keywords:  cerebral venous congestion intracranial hypertension headache venous outflow stenosis cerebral venous thrombosis

Received / Accepted:  16.05.2022 / 21.10.2022

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Abstract

The task of the review was to find the most appropriate definition and term, to identify a symptom complex of minimally pronounced clinical manifestations of intracranial hypertension in the presence of radiologically verified hemodynamically insignificant or insignificant, but obvious disorders of the outflow of venous blood from the cranial cavity through the dural venous sinuses of the brain, internal jugular and innominate veins.

As a result of an absentee discussion of many terms and classifications of clinical manifestations of such conditions, a compromise term "minimal cerebral venous insufficiency" is proposed for use, which does not include a reflection of the stage of the process, but only its pathophysiological component and mild severity. Regardless of the cause (intracranial or extracranial, intraluminal thrombosis or external stenosis/compression), the leading and often the only complaint may be "morning" headache with a score of 3 to 5 points on the visual-analog scale for the intensity of the headache, or a headache that occurs/increases with taking the patient in a horizontal position. There may be symptoms of "high pillow" and "sand in the eyes", pastosity of the face and eyelids in the morning, "machine" noise in the head, manifestations of asthenic syndrome, mild cognitive disorders in the form of poor assimilation of new knowledge and reduced concentration, manifestations of asthenic syndrome.

Only indirect signs of venous congestion can be detected by native computed tomography (CT). Magnetic resonance imaging, using T2* and SWI sequences in conjunction with MR venography, is considered the gold standard for visualizing abnormalities and pathology of cerebral venous vessels. In doubtful cases, contrast CT angiography becomes a verifying technique. Increased blood flow velocity in the direct sinus and vein of Galen, pseudopulsation are the most common Doppler patterns of cerebral venous insufficiency. Reliable direct visualization of stenosis and thrombi of the internal jugular veins with ultrasound, a new method for diagnosing cerebral venous stasis can be considered as an ultrasonic indicator of the arterio-venous ratio with a decrease to the level of 40–50%. Clinical manifestations of "minimal cerebral venous insufficiency" correlate with stenosis of the internal jugular veins in the range >50%<70%.

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About Authors

  • Stanislav E. Semenov, Dr. Med. Sci., Professor, Leading Researcher; ORCID
  • Mariya G. Shatokhina, Cand. Med. Sci., Head of Department of Radiology; ORCID
  • Dmitriy V. Bondarchuk, Radiologist; ORCID
  • Irina V. Moldavskaya, Cand. Med. Sci., Head of Regional Vascular Center, Head of Neurology Department; ORCID

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