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Titolo:
PRESENT STATUS OF COMPUTERIZED-TOMOGRAPHY AND ANGIOGRAPHY IN THE DIAGNOSIS OF CEREBRAL THROMBOPHLEBITIS CAVERNOUS SINUS THROMBOSIS EXCLUDED
Autore:
ANXIONNAT R; BLANCHET B; DORMONT D; BRACARD S; CHIRAS J; MAILLARD S; LOUAIL C; MORET C; BRAUN M; ROLAND J; MARSAULT C; PICARD L;
Indirizzi:
CHRU NANCY,SERV NEURORADIOL DIAGNOST & THERAPEUT,CASE OFFICIELLE 34 F-54035 NANCY FRANCE CHRU NANCY,SERV NEURORADIOL DIAGNOST & THERAPEUT,CASE OFFICIELLE 34 F-54035 NANCY FRANCE
Titolo Testata:
Journal of neuroradiology
fascicolo: 2, volume: 21, anno: 1994,
pagine: 59 - 71
SICI:
0150-9861(1994)21:2<59:PSOCAA>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
VENOUS THROMBOSIS; CHILDREN;
Keywords:
CEREBRAL THROMBOPHLEBITIS; ANGIOGRAPHY; COMPUTERIZED TOMOGRAPHY; MRL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
24
Recensione:
Indirizzi per estratti:
Citazione:
R. Anxionnat et al., "PRESENT STATUS OF COMPUTERIZED-TOMOGRAPHY AND ANGIOGRAPHY IN THE DIAGNOSIS OF CEREBRAL THROMBOPHLEBITIS CAVERNOUS SINUS THROMBOSIS EXCLUDED", Journal of neuroradiology, 21(2), 1994, pp. 59-71

Abstract

In order to evaluate the contribution of computerized tomography (CT)to the diagnosis of cerebral thrombophlebitis, a series of 28 cases was reviewed and compared with data from the literature. In an examination carried out 4 to 5 days of its constitution the thrombus may be directly, visualized as a spontaneous hyperdensity. This early but very transient sign, called <<cord sign>>, can easily be overlooked, which explains why it was found in only 5 of our 28 cases and in 2 % of the largest series of the literature. The thrombus thereafter becomes hypodense and can be intensified by peripheral contrast enhancement which produces the classical <<delta sign>>. This sign is more frequent: 13/28 in our series and 16 to 30 % in published cases. It is usually found in the superior sagittal sinus and must be distinguished from anatomical variations which are common at that level. These two direct signsacquire a grater value when associated with such indirect signs as diffuse or localized cerebral oedema (12 to 52 %) and venous ischaemia (22 to 59 %). Venous ischaemia is characterized by its strong bleeding potential (more than 50 % of the cases) and by its usually favourable course; these two elements and its site differentiate it from arterialischaemia. Finally, venous stasis is responsible, in 5 to 19 % of thecases, for intense enhancement of the tentorium cerebelli: this sign is not specific but easy to evidence and of great value when associated with a direct sign. Dilatation of cortical veins, found in 4 of our 28 cases, also seems to be an interesting sign which, to our knowledge, has not yet been mentioned in the literature. Since in 3.6 to 26 % of the cerebral thrombophlebites the CT scan is normal, a negative CT examination does not rule out this disease, and in many cases the exploration must be rapidly completed by angiography or MRI. Because it is non-invasive and very sensitive to flows, MRI has become the kev examination to assert the diagnosis. Angiography is now restricted to thosecases where cases where MRI cannot be performed promptly or to certain, purely cortical thrombophlebites which might pass unnoticed at MRI. When carried out and interpreted cautiously, angiography always showsthe venous thrombosis, its exact size and its suppletive network. Theresults of this study show that MRI alone can diagnose cerebral thrombophlebitis in most patients, that CT well done and interpreted often provides useful but seldom sufficient in&ces, and that angiography should be reserved for difficult cases.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 03:02:10