In some circumstances, confirming the venous origin of the lesion allows for the classification of stroke and the reduction of cryptogenic lesion data. The importance of venous stroke research is further enhanced by the fact that it occurs at a younger age than arterial stroke. The use of ultrasound to detect signs of intracranial venous stasis in combination with a visual-analogue scale to determine headache intensity allows us to suspect the venous genesis of ischemic stroke before using neuroimaging methods, which can aid in the selection of appropriate therapy and improve the prognosis and long-term outcomes of the disease. The goal of this study is to find evidence for the PCT-based hypothesis that venous ischemia in cerebral venous sinustrombosis is secondary to mechanical narrowing of arterioles in the area of vasogenic edoema and plethora, which leads to venous stroke developing earlier than arterial stroke against the backdrop of intracranial venous stasis.
Objective: To investigate and identify the most prognostically important rapid and available clinical and instrumental markers on a model of early differential diagnosis of ischemic stroke of arterial and venous origin.
Materials and Procedures: 124 patients with ischemic stroke were examined: 22 with venous stroke due to cerebral venous sinus thrombosis (VIS), 53.516.7 years old, and 102 with atherothrombotic stroke (AIS), 68.312.1 years old, all of whom were confirmed using native CT, CT-angiography, PCT (perfusion CT: CBF, CBV, MTT), brachiocephalic vessels ultrasound index of arteriovenous ratio (IAVR), IAVR was calculated using duplex scanning of the carotid common arteries (CCA) and internal jugular veins (IJV) using the formula: V max IJV optimal =2S CCA Vps CCA/ 3S IJV (1) IAVR = max IJV actual / V max IJV optimal 100 percent, where (2) IAVR – index of arteriovenous ratio, (percent) Vps CCA – peak sys
S – cross-sectional area of the vessel in cm2, as well.
Rating scales, including a visually analogue headache intensity scale, were employed to examine the neurological condition of patients.
Results: The indicator of arteriovenous blood flow ratio and the value of headache intensity on a visual-analogue scale were shown to have the greatest predictive importance. A model for the differential diagnosis of AIS and VIS has been created, with a high specificity of 98 percent and a sensitivity of 95.2 percent. Additional symptoms of cerebral venous stasis include velocity indicators in the Rosenthal and Galen veins.Author(S) Details
S. Semenov
Research Institute for Complex Issues of Cardiovascular Diseases, Russian Federation.
E. Yurkevich
Research Institute for Complex Issues of Cardiovascular Diseases, Russian Federation.
A. Semenov
Praxis Wolfgang Theobald Facharzt für Radiologie, Saarlouis, Germany.
View Book:- https://stm.bookpi.org/RDMMR-V15/article/view/4999
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