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Aguiar de Sousa D, Ferro JM, Canhão P, Barinagarrementeria F, Bousser MG, Stam J, Nogueira Pinto A, Viana Baptista M, Béjot Y, Dequatre-Ponchelle N. Cerebral Venous Thrombosis Causing Posterior Fossa Lesions: Description of a Case Series and Assessment of Safety of Anticoagulation. Cerebrovasc Dis 2014; 38:384-8. [DOI: 10.1159/000368999] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 10/13/2014] [Indexed: 11/19/2022] Open
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Ruiz-Sandoval JL, Chiquete E, Navarro-Bonnet J, Ochoa-Guzmán A, Arauz-Góngora A, Barinagarrementería F, Cantú C. Isolated Vein Thrombosis of the Posterior Fossa Presenting as Localized Cerebellar Venous Infarctions or Hemorrhages. Stroke 2010; 41:2358-61. [DOI: 10.1161/strokeaha.110.588202] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- José L. Ruiz-Sandoval
- From the Department of Neurology and Neurosurgery (J.L.R.-S., J.N.-B., A.O.-G.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” and the Department of Neurosciences, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Mexico; the Department of Internal Medicine (E.C.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Universidad de Guadalajara, Guadalajara, Mexico; and the Stroke Clinic (A.A.-G., F.B., C.C.), Instituto Nacional de Neurología y
| | - Erwin Chiquete
- From the Department of Neurology and Neurosurgery (J.L.R.-S., J.N.-B., A.O.-G.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” and the Department of Neurosciences, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Mexico; the Department of Internal Medicine (E.C.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Universidad de Guadalajara, Guadalajara, Mexico; and the Stroke Clinic (A.A.-G., F.B., C.C.), Instituto Nacional de Neurología y
| | - Jorge Navarro-Bonnet
- From the Department of Neurology and Neurosurgery (J.L.R.-S., J.N.-B., A.O.-G.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” and the Department of Neurosciences, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Mexico; the Department of Internal Medicine (E.C.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Universidad de Guadalajara, Guadalajara, Mexico; and the Stroke Clinic (A.A.-G., F.B., C.C.), Instituto Nacional de Neurología y
| | - Ana Ochoa-Guzmán
- From the Department of Neurology and Neurosurgery (J.L.R.-S., J.N.-B., A.O.-G.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” and the Department of Neurosciences, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Mexico; the Department of Internal Medicine (E.C.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Universidad de Guadalajara, Guadalajara, Mexico; and the Stroke Clinic (A.A.-G., F.B., C.C.), Instituto Nacional de Neurología y
| | - Antonio Arauz-Góngora
- From the Department of Neurology and Neurosurgery (J.L.R.-S., J.N.-B., A.O.-G.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” and the Department of Neurosciences, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Mexico; the Department of Internal Medicine (E.C.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Universidad de Guadalajara, Guadalajara, Mexico; and the Stroke Clinic (A.A.-G., F.B., C.C.), Instituto Nacional de Neurología y
| | - Fernando Barinagarrementería
- From the Department of Neurology and Neurosurgery (J.L.R.-S., J.N.-B., A.O.-G.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” and the Department of Neurosciences, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Mexico; the Department of Internal Medicine (E.C.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Universidad de Guadalajara, Guadalajara, Mexico; and the Stroke Clinic (A.A.-G., F.B., C.C.), Instituto Nacional de Neurología y
| | - Carlos Cantú
- From the Department of Neurology and Neurosurgery (J.L.R.-S., J.N.-B., A.O.-G.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” and the Department of Neurosciences, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Mexico; the Department of Internal Medicine (E.C.), Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Universidad de Guadalajara, Guadalajara, Mexico; and the Stroke Clinic (A.A.-G., F.B., C.C.), Instituto Nacional de Neurología y
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MASUOKA J, WAKAMIYA T, MINETA T, TAKASE Y, KAWASHIMA M, MATSUSHIMA T. Thrombosis of the Superior Petrosal Vein Mimicking Brain Tumor -Case Report-. Neurol Med Chir (Tokyo) 2009; 49:359-61. [DOI: 10.2176/nmc.49.359] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jun MASUOKA
- Department of Neurosurgery, Saga University Faculty of Medicine
| | | | | | - Yukinori TAKASE
- Department of Neurosurgery, Saga University Faculty of Medicine
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Abstract
The authors describe 2 cases of posterior fosa venous infarction. A 56-year-old woman with essential thrombocytemia presented with fluctuating complaints of headache, nausea, vomiting, left-sided numbness-weakness, and dizziness and became progressively stuporous. Cranial magnetic resonance imaging (MRI) showed bilateral parasagittal fronto-parietal and left cerebellar contrast-enhancing hemorrhagic lesions. On magnetic resonance venography, the left transverse and sigmoid sinuses were occluded. The second patient, a 39-year-old woman, presented with acute onset of diplopia, numbness of the tongue, vertigo, and right-sided weakness following a gestational age stillbirth. MRI revealed lesions in the right half of midbrain and pons and in the superior part of the right cerebellar hemisphere. Digital subtraction angiography showed right transverse and sigmoid sinus occlusion. The authors suggest that one should investigate the possibility of venous infarction in the presence of posterior fossa lesions that are often hemorrhagic and are not within any arterial territory distribution but respect a known venous drainage pattern. Recognition of the observed clinical and neuroimaging features can lead to earlier diagnosis and, potentially, more effective management.
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Affiliation(s)
- Y Krespi
- Department of Neurology, University of Istanbul School of Medicine, Istanbul, Turkey.
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Gaida-Hommernick B, von Smekal U, Kirsch M, Schminke U, Machetanz J, Kessler C. Bilateral cerebellar infarctions caused by a stenosis of a congenitally unpaired posterior inferior cerebellar artery. J Neuroimaging 2001; 11:435-7. [PMID: 11677886 DOI: 10.1111/j.1552-6569.2001.tb00075.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Bilateral symmetrical cerebellar infarcts in the territory supplied by the medial posterior inferior cerebellar artery (PICA) branches are extremely rare. In the few cases published, it has not been possible to clearly pinpoint the cause of this infarct pattern. The authors present the case history of a 58-year-old man who had acute headaches accompanied by pronounced rotatory vertigo with nausea and vomiting. The neurological examination revealed bilateral cerebellar signs. Cranial magnetic resonance imaging showed bilateral, nearly symmetrical infarcts in the territory of the medial branches of both PICAs. These bilateral PICA infarctions were caused by a stenosis of an unpaired PICA originating from the left vertebral artery supplying both cerebellar hemispheres.
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Affiliation(s)
- B Gaida-Hommernick
- Department of Neurology, Ernst Moritz Arndt University, Ellernholzstr 1-2, D-17487 Greifswald, Germany.
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Seoane E, Rhoton AL. Compression of the internal jugular vein by the transverse process of the atlas as the cause of cerebellar hemorrhage after supratentorial craniotomy. SURGICAL NEUROLOGY 1999; 51:500-5. [PMID: 10321879 DOI: 10.1016/s0090-3019(97)00476-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The cerebellar hemorrhage reported in numerous cases after supratentorial craniotomy has uniformly exhibited the characteristics of hemorrhage associated with venous infarction rather than arterial bleeding. The cause has remained obscure, although previous reports suggested that the cause may be obstruction of flow in the internal jugular vein immediately below the base of the skull. METHODS The microsurgical anatomy of 36 internal jugular veins in the upper cervical region were defined in adult cadaveric specimens using 3-40x magnification with special attention to the relationship of the vein to the atlas. RESULTS In every specimen, the posterior wall of the internal jugular vein rested against the transverse process of the atlas as the vein descended immediately below the jugular foramen. In 14 of 36 specimens, the transverse process indented the posterior wall of the vein, causing the vein to be slightly or moderately angulated as it descended across the anterior surface of the transverse process. Three veins were severely kinked as they descended across the transverse process of the atlas. CONCLUSIONS Obstruction of flow in the internal jugular vein at the site where the vein descends across the transverse process of the atlas is a likely cause of the venous hypertension that has resulted in the cerebellar hemorrhage reported in numerous cases after supratentorial craniotomy. An examination of the biomechanics of the region confirms that turning the head to the side opposite a supratentorial craniotomy and extending the neck, common practices with unilateral supratentorial craniotomy, further aggravates the angulation and obstruction of the internal jugular vein at the transverse process of C1 on the side ipsilateral to the craniotomy.
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Affiliation(s)
- E Seoane
- Department of Microsurgical Anatomy, University of Florida, Gainesville, USA
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Nayak AK, Karnad D, Mahajan MV, Shah A, Meisheri YV. Cerebellar venous infarction in chronic suppurative otitis media. A case report with review of four other cases. Stroke 1994; 25:1058-60. [PMID: 8165678 DOI: 10.1161/01.str.25.5.1058] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Cerebellar venous infarction is a rare condition. Thus far only four cases have been reported in the literature. We recently encountered a patient with chronic suppurative otitis media complicated by cerebellar venous infarction. The features of cerebellar venous infarction in the other four cases are also reviewed. CASE DESCRIPTION A 20-year-old man presented with clinical features suggestive of chronic suppurative otitis media. Computed tomographic scan of the brain revealed left mastoiditis with cholesteatoma and moderate communicating hydrocephalus. The patient was subjected to left radical mastoidectomy, and an attico-antral cholesteatoma was removed. Subsequently the patient developed clinical features suggestive of cerebellar abscess. A repeat computed tomographic scan revealed normal posterior fossa. Four-vessel angiography revealed left sigmoid and lateral sinus thrombosis and nonopacification of the left-sided cerebellar veins. Magnetic resonance imaging showed a venous infarct in the left cerebellar hemisphere. The patient was treated with cerebral dehydration measures. The patient subsequently improved and had no neurological deficit 3 months after surgery. CONCLUSIONS Although cerebellar venous infarction is rare, it can occur in chronic suppurative otitis media, pregnancy, antithrombin III deficiency, and diabetic osmolar coma. Sometimes no cause is found. Treatment includes correction of the underlying cause. The presence of a hemorrhagic lesion on computed tomographic scan and deep coma at presentation indicate poor prognosis.
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Affiliation(s)
- A K Nayak
- Department of Medicine, Seth G.S. Medical College and K.E.M. Hospital, Bombay, India
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