Extension of intracranial thrombosis after unilateral dissection of the internal jugular vein
| Autor: | Karl-Bernd Hüttenbrink, E. G. Wüstenberg, Christian Offergeld, Thomas Kittner, Thomas Zahnert |
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| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Magnetic resonance angiography medicine Humans Prospective Studies Vein Internal jugular vein Intracranial pressure Aged Sigmoid sinus medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease Thrombosis Magnetic Resonance Imaging Surgery Intracranial Thrombosis medicine.anatomical_structure Otorhinolaryngology cardiovascular system Neck Dissection Female Radiology Jugular Veins business Lower limbs venous ultrasonography Magnetic Resonance Angiography |
| Zdroj: | Archives of otolaryngology--headneck surgery. 131(5) |
| ISSN: | 0886-4470 |
| Popis: | Objective Resection of the internal jugular vein can be necessary in cases of radical neck dissection or even in cases involving benign neoplasms such as glomus tumors. According to the triad described by Virchow (ie, stasis of blood flow, damage to the endothelium, and changes in hemostasis), the development of a thrombosis in the venous vessels superior to the resected internal jugular vein seems to be possible. The aim of this study was to determine the extension of possible intracranial thrombosis after wound healing. Design A total of 17 patients requiring resection of the internal jugular vein were evaluated prospectively using magnetic resonance imaging and 2-dimensional (time-of-flight) magnetic resonance angiography after the surgical treatment. Preoperative magnetic resonance images were obtained in all 17 patients for staging purposes as well as to exclude preoperative thrombosis of the internal jugular vein. Sixteen patients had malignant tumors, and 1 patient had a glomus tumor. Results Intracranial thrombosis with thrombosis of the sigmoid sinus was found in 4 patients, and thrombosis of the transverse sinus was found in 3 patients. There were no complications such as intracranial hemorrhage or signs of increased intracranial pressure in any patients. There was no evidence of intracranial thrombosis in 10 cases. In these cases, thrombosis of the venous vessels superior to the resected vein ranged from none to complete thrombosis of the superior bulb of the internal jugular vein. After unilateral resection of the internal jugular vein, the venous blood leaves the brain mainly via the venous network of the contralateral side of the neck. Conclusions Although intracranial thrombosis of the sigmoid or transverse sinus seems to occur more frequently than was previously thought, intracranial complications such as venous infarction or increased intracranial pressure appear to be very rare. After unilateral radical neck dissection, the venous blood leaves the brain mainly via the venous system of the other side of the neck and the ipsilateral collateral veins. |
| Databáze: | OpenAIRE |
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