Journal «Angiology and Vascular Surgery» • 

1998 • VOLUME 4 • №1

CEREBRAL VENOUS CIRCULATION IN PATIENTS WITH BENIGN INTRACRANIAL HYPERTENSION

V.A. Shakhnovich, A.A. Galushkina
Group of Clinical Pathology of Cerebral Circulation,
Academician N.N. Burdenko Research Institute,
Moscow, Russia

The origination of benign intracranial hypertension may depend on various disorders in the outflow of cerebral venous blood and the cerebrospinal fluid (CSF) the cranial cavity. The aim of the present work was to identify the peculiarities of venous circulation in patients suffering from benign intracranial hypertension on the basis of the we oforthostatic loads. The studies were carried out in two groups. The first group included 12 normal subjects (6 women and 6 men) aged 12 to 50 years. The second group consisted of 12 patients (8 women and 4 men) aged 11 to 51 years with benign intracranial hypertension. Of these, 9 patients presented with cerebral arachnoiditis and the remainderwith thromboses of aura. mater sinuses: of the superior sagittal sinus (2 patients) and of the transverse sinus (1 patient). Transcranial Doppler was employed to record the linear blood flow velocity in the straight cerebral sinus under orthostatic loads (changes in body position) from ortho- (+75°) to antiorthoposition (–45°), with blood flow evaluation in the horizontal position as well. Insonation of the straight cerebral sinus was performed via the occipital window. In the first group (normal subjects), the orthoload gave rise to a decrease in the linear blood flow velocity by 2-10 cm/s (7-33%) whereas in the antiorthoposition, the linear blood flow velocity rose by 3-12 cm/s (11-33%). In the second group (patients with benign intracranial hypertension), the changes in the body position resulted in pathological alterations in the linear blood flow velocity. For instance, under ortholoads this was observed in 4 patients and was marked by a fall in the linear blood flow velocity by 13-40 cm/a (38-66%) under antiortho-loads, this was observed to 3 patients and was marked by blood flow enhancement by 16-41 cm/s (45-97%); in 5 patients, it was seen under ortho- and antiortholoads and was marked by a fall ill the linear blood flow velocity to 41 cm/s and by its rise up to 60 cm/s (100%). Such an appreciable difference in disorders of venous blood flow response to ortho- and antiortholoads in patients with benign intracranial hypertension may be explained by different character of disorders of cerebral venous circu -lotion. In thrombosis of the transverse sinus, a selective considerable decrease (by 50%) in the linear blood flow velocity was observed under orthoload whereas in the horizontal position, it was normal. In the remaining patients of this group, the linear blood flow velocity in the horizontal position was higher (33-76 cm/s) as compared to normal (14-28 cm/s). Thus, ortho- and antiortholoads permit identification of different types of disorders in cerebral venous circulation in patients with benign intracranial hypertension.

P. 65-71

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