Transient Global Amnesia: Cerebral Venous Outflow Impairment-Insight from the Abnormal Flow Patterns of the Internal Jugular Vein

Chih Ping Chung, Hung Y. Hsu, A. Ching Chao, Wen Yung Sheng, Bing W. Soong, Han H. Hu

研究成果: 雜誌貢獻文章

40 引文 (Scopus)

摘要

Cerebral venous reflux is found frequently in transient global amnesia (TGA) patients. The cerebral venous reflux mostly results from left brachiocephalic venous obstruction, and the level of reflux depends on different respiratory status. For further understanding of the role of venous outflow impairment in the pathogenesis of TGA, we used color duplex sonography to reveal the flow patterns in the internal jugular vein (IJV) and its branches (JB) under different respiratory conditions. We compared the frequency of abnormal venous flow of IJV and/or JB on color duplex sonography between 17 TGA patients and 17 age- and gender-matched normal individuals both at rest (regular breathing) and at deep inspiration. Further, these venous-flow abnormalities in IJV and JB were well described. Cranial 3-D time-of-flight magnetic resonance arteriography (MRA) were performed in all patients three to seven days after their TGA attacks and in all normal individuals to analyze the abnormal flow signals in the intracranial venous structures. In the result, abnormal flow-patterns in the left IJV and/or left JB during regular breathing were found more frequently in TGA patients than normal individuals (65% vs. 6%; p < 0.001). These abnormalities in TGA patients were (1) isolated reversed flow in the left JB, (2) segmental reversed flow in the left distal IJV and (3) continuous reversed flow in the left IJV and JB. The MRA study revealed that only the most severe reflux in the IJV causes intracranial venous reflux; six were in the group of continuous reversed flow in left IJV and one was in the group of segmental reversed flow in left distal IJV. These findings suggest that TGA might be one of the clinical manifestations of the "cerebral-type intermittent venous claudication," which stems from cerebral venous outflow impairment, insufficient venous collaterals and specific precipitating factors. (E-mail: hhhu@vghtpe.gov.tw).
原文英語
頁(從 - 到)1727-1735
頁數9
期刊Ultrasound in Medicine and Biology
33
發行號11
DOIs
出版狀態已發佈 - 十一月 1 2007
對外發佈Yes

指紋

Transient Global Amnesia
Jugular Veins
impairment
veins
flow distribution
reversed flow
abnormalities
breathing
magnetic resonance
Ultrasonography
Angiography
Respiration
Magnetic Resonance Spectroscopy
Color
color
inspiration
Precipitating Factors
pathogenesis
Intermittent Claudication
stems

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

引用此文

Transient Global Amnesia : Cerebral Venous Outflow Impairment-Insight from the Abnormal Flow Patterns of the Internal Jugular Vein. / Chung, Chih Ping; Hsu, Hung Y.; Chao, A. Ching; Sheng, Wen Yung; Soong, Bing W.; Hu, Han H.

於: Ultrasound in Medicine and Biology, 卷 33, 編號 11, 01.11.2007, p. 1727-1735.

研究成果: 雜誌貢獻文章

Chung, Chih Ping ; Hsu, Hung Y. ; Chao, A. Ching ; Sheng, Wen Yung ; Soong, Bing W. ; Hu, Han H. / Transient Global Amnesia : Cerebral Venous Outflow Impairment-Insight from the Abnormal Flow Patterns of the Internal Jugular Vein. 於: Ultrasound in Medicine and Biology. 2007 ; 卷 33, 編號 11. 頁 1727-1735.
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abstract = "Cerebral venous reflux is found frequently in transient global amnesia (TGA) patients. The cerebral venous reflux mostly results from left brachiocephalic venous obstruction, and the level of reflux depends on different respiratory status. For further understanding of the role of venous outflow impairment in the pathogenesis of TGA, we used color duplex sonography to reveal the flow patterns in the internal jugular vein (IJV) and its branches (JB) under different respiratory conditions. We compared the frequency of abnormal venous flow of IJV and/or JB on color duplex sonography between 17 TGA patients and 17 age- and gender-matched normal individuals both at rest (regular breathing) and at deep inspiration. Further, these venous-flow abnormalities in IJV and JB were well described. Cranial 3-D time-of-flight magnetic resonance arteriography (MRA) were performed in all patients three to seven days after their TGA attacks and in all normal individuals to analyze the abnormal flow signals in the intracranial venous structures. In the result, abnormal flow-patterns in the left IJV and/or left JB during regular breathing were found more frequently in TGA patients than normal individuals (65{\%} vs. 6{\%}; p < 0.001). These abnormalities in TGA patients were (1) isolated reversed flow in the left JB, (2) segmental reversed flow in the left distal IJV and (3) continuous reversed flow in the left IJV and JB. The MRA study revealed that only the most severe reflux in the IJV causes intracranial venous reflux; six were in the group of continuous reversed flow in left IJV and one was in the group of segmental reversed flow in left distal IJV. These findings suggest that TGA might be one of the clinical manifestations of the {"}cerebral-type intermittent venous claudication,{"} which stems from cerebral venous outflow impairment, insufficient venous collaterals and specific precipitating factors. (E-mail: hhhu@vghtpe.gov.tw).",
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