Hypoplasia of the ipsilateral internal jugular vein is associated with worse outcome in acute anterior circulation stroke

Background/Aim. Disruption of cerebral venous blood drainage leads to cerebral venous congestion, an increase in intracranial pressure and decrease of the cerebral perfusion pressure. The exact role of the cerebral venous circulation in acute stroke is not yet known. The main blood drainage from the...

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Main Authors: Vukičević Marjana, Georgievski-Brkić Biljana, Jaramaz-Duić Tatjana, Vojvodić Ljubica, Mileusnić Valentina, Raičević Ranko
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2019-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2019/0042-84501700092V.pdf
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author Vukičević Marjana
Georgievski-Brkić Biljana
Jaramaz-Duić Tatjana
Vojvodić Ljubica
Mileusnić Valentina
Raičević Ranko
author_facet Vukičević Marjana
Georgievski-Brkić Biljana
Jaramaz-Duić Tatjana
Vojvodić Ljubica
Mileusnić Valentina
Raičević Ranko
author_sort Vukičević Marjana
collection DOAJ
description Background/Aim. Disruption of cerebral venous blood drainage leads to cerebral venous congestion, an increase in intracranial pressure and decrease of the cerebral perfusion pressure. The exact role of the cerebral venous circulation in acute stroke is not yet known. The main blood drainage from the brain and the superficial parts of the face and neck is drained by a paired internal jugular vein (IJV). Congenital anomalies of IJV may disrupt the blood collection from the brain, which leads to congestion of the cerebral venous circulation. The aim of our study was to determine the association between the hypoplastic ipsilateral IJV and clinical outcome of patients with acute ischemic anterior circulation stroke. Methods. This prospective case series study involved the patients with the anterior circulation stroke and ultrasonographic criteria for unilateral hypoplasia of the ipsilateral IJV. Data from the 74 consecutive patients with acute anterior circulation stroke admitted to the Special Hospital for Cerebrovascular Diseases “Sveti Sava”, Belgrade, from September 2015 to January 2016 were included. Ultrasonography of IJV diameter and the collection of the hemodynamic data were performed in all patients. Neurological deficits on admission were evaluated using the National Institutes of Health Stroke Scale (NIHSS) score. The clinical outcome was assessed using the modified Rankin Scale (mRS) score (from 0 to 6) at 30 days or at discharge, whichever occurred sooner. Good and poor outcomes were defined as an mRS score of 0–2 and 3–6, respectively. Results. Ipsilateral hypoplastic IJV was diagnosed in 13 (17.6%) patients with anterior circulation stroke. In this group, 9 stroke patients (69.2%) had mRS ≥ 3. Of the remaining 4 patients with mRS ≤ 2, three had bilateral hypoplasia of IJV and one patient had smaller diameter of the IJV, but did not fulfill the ultrasonographic criteria for hypoplastic venous anomaly. Conclusions. In our case, a series of the patients with anterior circulation stroke with ultrasonographic criteria for unilateral hypoplasia of the ipsilateral IJV (on stroke side) have worse clinical outcome compared with the patients with bilateral hypoplasia.
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spelling doaj-art-30fdca7bd4714048a1ffeeb6dd70a21b2025-08-20T02:01:34ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202019-01-0176330731210.2298/VSP170118092V0042-84501700092VHypoplasia of the ipsilateral internal jugular vein is associated with worse outcome in acute anterior circulation strokeVukičević Marjana0Georgievski-Brkić Biljana1Jaramaz-Duić Tatjana2Vojvodić Ljubica3Mileusnić Valentina4Raičević Ranko5Special Hospital for Cerebrovascular diseases "Sveti Sava", BelgradeSpecial Hospital for Cerebrovascular diseases "Sveti Sava", BelgradeSpecial Hospital for Cerebrovascular diseases "Sveti Sava", BelgradeSpecial Hospital for Cerebrovascular diseases "Sveti Sava", BelgradeSpecial Hospital for Cerebrovascular diseases "Sveti Sava", BelgradeMilitary Medical Academy, Clinic of neurology, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeBackground/Aim. Disruption of cerebral venous blood drainage leads to cerebral venous congestion, an increase in intracranial pressure and decrease of the cerebral perfusion pressure. The exact role of the cerebral venous circulation in acute stroke is not yet known. The main blood drainage from the brain and the superficial parts of the face and neck is drained by a paired internal jugular vein (IJV). Congenital anomalies of IJV may disrupt the blood collection from the brain, which leads to congestion of the cerebral venous circulation. The aim of our study was to determine the association between the hypoplastic ipsilateral IJV and clinical outcome of patients with acute ischemic anterior circulation stroke. Methods. This prospective case series study involved the patients with the anterior circulation stroke and ultrasonographic criteria for unilateral hypoplasia of the ipsilateral IJV. Data from the 74 consecutive patients with acute anterior circulation stroke admitted to the Special Hospital for Cerebrovascular Diseases “Sveti Sava”, Belgrade, from September 2015 to January 2016 were included. Ultrasonography of IJV diameter and the collection of the hemodynamic data were performed in all patients. Neurological deficits on admission were evaluated using the National Institutes of Health Stroke Scale (NIHSS) score. The clinical outcome was assessed using the modified Rankin Scale (mRS) score (from 0 to 6) at 30 days or at discharge, whichever occurred sooner. Good and poor outcomes were defined as an mRS score of 0–2 and 3–6, respectively. Results. Ipsilateral hypoplastic IJV was diagnosed in 13 (17.6%) patients with anterior circulation stroke. In this group, 9 stroke patients (69.2%) had mRS ≥ 3. Of the remaining 4 patients with mRS ≤ 2, three had bilateral hypoplasia of IJV and one patient had smaller diameter of the IJV, but did not fulfill the ultrasonographic criteria for hypoplastic venous anomaly. Conclusions. In our case, a series of the patients with anterior circulation stroke with ultrasonographic criteria for unilateral hypoplasia of the ipsilateral IJV (on stroke side) have worse clinical outcome compared with the patients with bilateral hypoplasia.http://www.doiserbia.nb.rs/img/doi/0042-8450/2019/0042-84501700092V.pdfbrain infarctionjugular veinsechocardiography, dopplertreatment outcome
spellingShingle Vukičević Marjana
Georgievski-Brkić Biljana
Jaramaz-Duić Tatjana
Vojvodić Ljubica
Mileusnić Valentina
Raičević Ranko
Hypoplasia of the ipsilateral internal jugular vein is associated with worse outcome in acute anterior circulation stroke
Vojnosanitetski Pregled
brain infarction
jugular veins
echocardiography, doppler
treatment outcome
title Hypoplasia of the ipsilateral internal jugular vein is associated with worse outcome in acute anterior circulation stroke
title_full Hypoplasia of the ipsilateral internal jugular vein is associated with worse outcome in acute anterior circulation stroke
title_fullStr Hypoplasia of the ipsilateral internal jugular vein is associated with worse outcome in acute anterior circulation stroke
title_full_unstemmed Hypoplasia of the ipsilateral internal jugular vein is associated with worse outcome in acute anterior circulation stroke
title_short Hypoplasia of the ipsilateral internal jugular vein is associated with worse outcome in acute anterior circulation stroke
title_sort hypoplasia of the ipsilateral internal jugular vein is associated with worse outcome in acute anterior circulation stroke
topic brain infarction
jugular veins
echocardiography, doppler
treatment outcome
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2019/0042-84501700092V.pdf
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