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Abstract Details

Feasibility of Insonation of Intracranial Cerebral Venous System via Transcranial Doppler Ultrasound in Distinguishing Venous Hypertension in Patients with Chronic Idiopathic Intracranial Hypertension
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
183
To investigate the feasibility of Transcranial Doppler Ultrasound in insonation of the cerebral venous system and distinguishing venous hypertension. Venous velocity measurements using ultrasound can function as a non-invasive diagnostic modality for cerebral venous assessment in diseases where venous sinus pathology might be implicated in disease pathophysiology.
Emerging literature has implicated transverse venous sinus stenosis and venous hypertension as a contributing factor in the pathogenesis of chronic idiopathic intracranial hypertension (IIH). Currently, diagnosis depends on invasive tests like lumbar puncture and venous angiography. A non-invasive method of venous sinus assessment would benefit both patients and clinicians in the diagnosis and management of patients with suspected IIH.
Ongoing prospective case control study approved by institutional review board. We insonated the internal jugular vein (IJV), deep middle cerebral veins (DMCV), basilar vein of Rosenthal (BVR) and transverse venous sinus (TS) in 20 healthy volunteers as controls, and recorded mean flow velocities and pulsatility indices. Study is beginning enrollment of 20 patients with established diagnosis of IIH to gather venous velocities on ultrasound, venous pressures on angiography, and presence of transverse venous sinus stenosis on angiogram.
Twenty healthy volunteers were insonated for three intracranial venous structures – DMCV, BVR, TS – bilaterally. Eight sites did not yield measureable results (2 DMCV, 2 BVR, 4 TS). IJV insonation was not attempted in five sites (3 subjects). Average velocities and pulsatility indices for insonated vessels (cm/s): RDMCV [11.7, 0.633], LDMCV [10.12, 0.67], RBVR [10.78, 0.47], LBVR [12.87, 0.70], RTS [14.23, 0.44], LTS [13.54, 0.56] respectively.
Transcranial Doppler imaging of cerebral venous system is feasible and reproducible. Role and potential utility of venous TCDs in the diagnosis of venous hypertension in patients with suspected IIH is being explored. Enrollment of IIH patients will allow assessment of venous TCD values as a method for distinguishing venous hypertension.
Authors/Disclosures
Vivek Krishnan
PRESENTER 		Vivek Krishnan has nothing to disclose.
No disclosure on file
John Levi (Wake Forest School of Medicine) John Levi has nothing to disclose.
Charles H. Tegeler, MD (Wake Forest School of Medicine) Dr. Tegeler has nothing to disclose.
Aarti Sarwal, MD, FÂ鶹´«Ã½Ó³»­ Dr. Sarwal has received personal compensation in the range of $0-$499 for serving as a Consultant for Stimdia, Inc. Dr. Sarwal has received personal compensation in the range of $0-$499 for serving as a Consultant for Sheinkei. Dr. Sarwal has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Society of Critical Care Medicine . Dr. Sarwal has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Society of Neuroimaging . The institution of Dr. Sarwal has received research support from Butterfly, Inc. The institution of Dr. Sarwal has received research support from Bard. The institution of Dr. Sarwal has received research support from Biogen. The institution of Dr. Sarwal has received research support from Novartis. The institution of Dr. Sarwal has received research support from CVR Global. The institution of Dr. Sarwal has received research support from NIH/NIA R01 AG066910-01 . The institution of Dr. Sarwal has received research support from Image Monitoring. Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Speaker/Faculty, CME courses with Society of Critical Care Medicine . Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Speaker at annual congress with Intensive Care Society. Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Speaker at annual congress with Indian Society of Critical Care. Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a speaker/Faculty for Annual meeting, travel compensation with European Society of Intensive Care Medicine. Dr. Sarwal has received personal compensation in the range of $500-$4,999 for serving as a Speaker with ISICEM. Dr. Sarwal has a non-compensated relationship as a Social Media Editor with Neurocritical Care that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Sarwal has a non-compensated relationship as a Secretary with American Society of Neuroimaging that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Sarwal has a non-compensated relationship as a President with Association of Indian Neurologists in America that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Sarwal has a non-compensated relationship as a Member, Board of Directors with Neurocritical Care Society that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Sarwal has a non-compensated relationship as a Section Chair, Neurosciences Section with Society of Critical Care Medicine that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.