title: Venous hypertension may be a factor in aneurysmal rupture. A case report.
abstract: This report describes cerebral aneurysmal rupture with asymmetry of ipsilateral dural sinus hypoplasia using quantitative color-coded I-Flow cerebral venography to identify the venous pressure gradient. We suggest the pressure gradient may be a potential factor in cerebral aneurysmal rupture. We used I-Flow quantitative cerebral venography to measure the venous pressure gradient during acute cerebral aneurysmal rupture and post embolization in a 67-year-old woman who presented with clinical symptoms of left third nerve palsy for several days with mild headache initially without subarachnoid hemorrhage. We encountered a high venous pressure gradient of severe ipsilateral dural sinus hypoplasia during acute rupture of a posterior communicating aneurysm. Venous dural sinus asymmetry has been considered a congenital benign and non-pathological condition. However, this case may present severe hypoplasia of the dural sinus with potential pressure gradient in some unusual condition. A high venous pressure gradient may be another factor in cerebral aneurysmal rupture.
authors.affiliation: Imaging Research Center, Taipei Medical University, Taipei, Taiwan.
authors.forename: K-W
authors.initials: KW
authors.lastname: Lee
authors.forename: F Y
authors.initials: FY
authors.lastname: Tsai
authors.forename: C-Y
authors.initials: CY
authors.lastname: Cheng
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000209:etiology*; D010690:Phlebography; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology; D014057:Tomography, X-Ray Computed