Detection of intracranial venous reflux in patients of transient global amnesia

C. P. Chung, H. Y. Hsu, A. C. Chao, F. C. Chang, W. Y. Sheng, H. H. Hu

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

BACKGROUND: The mechanism of transient global amnesia (TGA) is not clear. Attempting to support the hypothesis that retrograde venous hypertension causing cerebral venous ischemia plays a role in the pathogenesis of TGA, the authors used cranial three-dimensional time-of-flight (TOF) MR angiography (MRA) to detect a possible intracranial retrograde venous flow in TGA patients. METHODS: The frequency of abnormal venous signals on cranial three-dimensional TOF MRA was compared in 10 TGA patients with the signals in 50 age- and gender-matched normal individuals. In TGA patients with abnormal venous signals, other examinations (cerebral digital subtraction angiography, upper extremity digital subtraction venography [DSV], and thoracic inlet MRI) were performed to elucidate the etiology of these abnormal intracranial venous flow patterns. RESULTS: Abnormal venous signals on three-dimensional TOF MRA were found in five (50%) of the TGA patients and none of the control subjects (p < 0.001). Compression leading to occlusion of the left brachiocephalic vein by the sternum and aorta during regular breathing, as depicted by upper extremity DSV and thoracic inlet MRI, occurred consistently among these five TGA patients with abnormal venous signals. CONCLUSIONS: Retrograde intracranial venous flow caused by left brachiocephalic vein occlusion was found only in patients with transient global amnesia (TGA). This result suggests that TGA patients may have an underlying impairment of cerebral venous outflow that increases their vulnerability to TGA attack.

Original languageEnglish
Pages (from-to)1873-1877
Number of pages5
JournalNeurology
Volume66
Issue number12
DOIs
Publication statusPublished - Jun 1 2006
Externally publishedYes

Fingerprint

Transient Global Amnesia
Brachiocephalic Veins
Angiography
Phlebography
Upper Extremity
Thorax
Cerebral Angiography
Sternum
Digital Subtraction Angiography
Brain Ischemia
Aorta
Respiration

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Detection of intracranial venous reflux in patients of transient global amnesia. / Chung, C. P.; Hsu, H. Y.; Chao, A. C.; Chang, F. C.; Sheng, W. Y.; Hu, H. H.

In: Neurology, Vol. 66, No. 12, 01.06.2006, p. 1873-1877.

Research output: Contribution to journalArticle

Chung, C. P. ; Hsu, H. Y. ; Chao, A. C. ; Chang, F. C. ; Sheng, W. Y. ; Hu, H. H. / Detection of intracranial venous reflux in patients of transient global amnesia. In: Neurology. 2006 ; Vol. 66, No. 12. pp. 1873-1877.
@article{4fd3b86147be499d896dae677f3ae0d4,
title = "Detection of intracranial venous reflux in patients of transient global amnesia",
abstract = "BACKGROUND: The mechanism of transient global amnesia (TGA) is not clear. Attempting to support the hypothesis that retrograde venous hypertension causing cerebral venous ischemia plays a role in the pathogenesis of TGA, the authors used cranial three-dimensional time-of-flight (TOF) MR angiography (MRA) to detect a possible intracranial retrograde venous flow in TGA patients. METHODS: The frequency of abnormal venous signals on cranial three-dimensional TOF MRA was compared in 10 TGA patients with the signals in 50 age- and gender-matched normal individuals. In TGA patients with abnormal venous signals, other examinations (cerebral digital subtraction angiography, upper extremity digital subtraction venography [DSV], and thoracic inlet MRI) were performed to elucidate the etiology of these abnormal intracranial venous flow patterns. RESULTS: Abnormal venous signals on three-dimensional TOF MRA were found in five (50{\%}) of the TGA patients and none of the control subjects (p < 0.001). Compression leading to occlusion of the left brachiocephalic vein by the sternum and aorta during regular breathing, as depicted by upper extremity DSV and thoracic inlet MRI, occurred consistently among these five TGA patients with abnormal venous signals. CONCLUSIONS: Retrograde intracranial venous flow caused by left brachiocephalic vein occlusion was found only in patients with transient global amnesia (TGA). This result suggests that TGA patients may have an underlying impairment of cerebral venous outflow that increases their vulnerability to TGA attack.",
author = "Chung, {C. P.} and Hsu, {H. Y.} and Chao, {A. C.} and Chang, {F. C.} and Sheng, {W. Y.} and Hu, {H. H.}",
year = "2006",
month = "6",
day = "1",
doi = "10.1212/01.wnl.0000219620.69618.9d",
language = "English",
volume = "66",
pages = "1873--1877",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Detection of intracranial venous reflux in patients of transient global amnesia

AU - Chung, C. P.

AU - Hsu, H. Y.

AU - Chao, A. C.

AU - Chang, F. C.

AU - Sheng, W. Y.

AU - Hu, H. H.

PY - 2006/6/1

Y1 - 2006/6/1

N2 - BACKGROUND: The mechanism of transient global amnesia (TGA) is not clear. Attempting to support the hypothesis that retrograde venous hypertension causing cerebral venous ischemia plays a role in the pathogenesis of TGA, the authors used cranial three-dimensional time-of-flight (TOF) MR angiography (MRA) to detect a possible intracranial retrograde venous flow in TGA patients. METHODS: The frequency of abnormal venous signals on cranial three-dimensional TOF MRA was compared in 10 TGA patients with the signals in 50 age- and gender-matched normal individuals. In TGA patients with abnormal venous signals, other examinations (cerebral digital subtraction angiography, upper extremity digital subtraction venography [DSV], and thoracic inlet MRI) were performed to elucidate the etiology of these abnormal intracranial venous flow patterns. RESULTS: Abnormal venous signals on three-dimensional TOF MRA were found in five (50%) of the TGA patients and none of the control subjects (p < 0.001). Compression leading to occlusion of the left brachiocephalic vein by the sternum and aorta during regular breathing, as depicted by upper extremity DSV and thoracic inlet MRI, occurred consistently among these five TGA patients with abnormal venous signals. CONCLUSIONS: Retrograde intracranial venous flow caused by left brachiocephalic vein occlusion was found only in patients with transient global amnesia (TGA). This result suggests that TGA patients may have an underlying impairment of cerebral venous outflow that increases their vulnerability to TGA attack.

AB - BACKGROUND: The mechanism of transient global amnesia (TGA) is not clear. Attempting to support the hypothesis that retrograde venous hypertension causing cerebral venous ischemia plays a role in the pathogenesis of TGA, the authors used cranial three-dimensional time-of-flight (TOF) MR angiography (MRA) to detect a possible intracranial retrograde venous flow in TGA patients. METHODS: The frequency of abnormal venous signals on cranial three-dimensional TOF MRA was compared in 10 TGA patients with the signals in 50 age- and gender-matched normal individuals. In TGA patients with abnormal venous signals, other examinations (cerebral digital subtraction angiography, upper extremity digital subtraction venography [DSV], and thoracic inlet MRI) were performed to elucidate the etiology of these abnormal intracranial venous flow patterns. RESULTS: Abnormal venous signals on three-dimensional TOF MRA were found in five (50%) of the TGA patients and none of the control subjects (p < 0.001). Compression leading to occlusion of the left brachiocephalic vein by the sternum and aorta during regular breathing, as depicted by upper extremity DSV and thoracic inlet MRI, occurred consistently among these five TGA patients with abnormal venous signals. CONCLUSIONS: Retrograde intracranial venous flow caused by left brachiocephalic vein occlusion was found only in patients with transient global amnesia (TGA). This result suggests that TGA patients may have an underlying impairment of cerebral venous outflow that increases their vulnerability to TGA attack.

UR - http://www.scopus.com/inward/record.url?scp=33745894626&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745894626&partnerID=8YFLogxK

U2 - 10.1212/01.wnl.0000219620.69618.9d

DO - 10.1212/01.wnl.0000219620.69618.9d

M3 - Article

VL - 66

SP - 1873

EP - 1877

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 12

ER -