脑血管介入评估脑静脉窦与特发性颅内压增高相关性

目的 探讨采用脑血管内介入方法评估脑静脉窦与特发性颅内压增高(ⅡH)的相关性.方法 回顾性分析13例临床诊断ⅡH患者资料.完善相关临床症状、体征、实验室、MR静脉成像(MRV)等检查.局部麻醉下作全脑血管DSA造影,同时超选至静脉窦作矢状窦、横窦、乙状窦、颈静脉分段测压.结果 脑血管DSA检查显示,13例患者中静脉窦狭窄或闭塞10例(76.9％),其中横窦6例,乙状窦3例,横窦和乙状窦同时受累l例.静脉窦超选测压显示,10例患者静脉窦狭窄两端压力差达120～580 mmH2O;8例(61.5％,8/13)静脉窦闭塞/狭窄可能与ⅡH相关,2例(15.4％,2/13)静脉窦狭窄可能继发于ⅡH,3例(23.1％,3/13)静脉窦狭窄可能与ⅡH无关.结论 脑血管内介入造影结合静脉窦超选测压,能够良好地辨别ⅡH与静脉窦的关系.

Evaluation of the correlation between cerebral venous sinus and idiopathic intracranial hypertension with cerebrovascular intervention technique

Objective To discuss the application of cerebrovascular intervention technique in evaluating the correlation between cerebral venous sinus and idiopathic intracranial hypertension (ⅡH).Methods The clinical data,including complete related clinical signs and symptoms,laboratory results,magnetic resonance venography (MRV) findings,etc.,of 13 ⅡH patients were retrospectively analyzed.Under local anesthesia whole brain DSA was performed,and superselective catheterization of venous sinus was accomplished to perform sectional pressure measurement of sagittal sinus,transverse sinus,sigmoid sinus and jugular vein.Results Cerebral DSA examination revealed that venous sinus stenosis or occlusion was seen in 10 patients (76.9％),including transverse sinus (n=6),sigmoid sinus (n=3),and transverse sinus together with sigmoid sinus (n=l).Superselective pressure neasurement of venous sinus showed that the pressure difference between the two ends of the narrowed venous sinus was up to 120-580 mmH20 in these 10 patients.In 8 patients (61.5％,8/13) the venous sinus stenosis and/or occlusion might be implicated in the occurrence of ⅡH,in 2 patients (15.4％,2/13) the venous sinus stenosis might be secondary to ⅡH,and in 3 patients (23.1％,3/13) the venous sinus stenosis might bear no relationship to ⅡH.Conclusion Cerebrovascular interventional angiography combined with superselective pressure measurement of venous sinus can clearly identify the relationship between ⅡH and venous sinus