Stroke, Vol 24, 563-569, Copyright © 1993 by American Heart Association
K Ungersbock, A Heimann and O Kempski
BACKGROUND AND PURPOSE: Outcome from sinus vein thrombosis is very
variable, with symptoms from headache to coma. Experimental findings
suggest that an involvement of cortical veins is necessary to affect the
cerebral microcirculation. Laser Doppler flowmetry was used to investigate
the regional and temporal changes in local cortical blood flow after
experimental occlusion and thrombosis of the superior sagittal sinus and
tributary cortical veins in rats. METHODS: Thrombosis was induced by slow
injection of kaolin-cephalin suspension after frontal and caudal ligation
of the sagittal sinus in rats. Local cerebral blood flow was measured by
laser Doppler flowmetry and correlated with parenchymal damage found 24
hours after induction of thrombosis. RESULTS: Local cerebral blood flow 1
hour after sinus occlusion and induction of thrombosis had decreased to
60.92 +/- 29.05% (p < 0.01); however, there was a large variability
among individual animals. Only five of 12 rats showed histological damage
and intracerebral hemorrhages 24 hours after induction of thrombosis. A
subgroup analysis revealed that parenchymal damage occurred in concurrence
with reduced blood flow values after sinus ligation and injection of the
thrombogenic material. Sinus thrombosis alone, without alteration of blood
flow, did not cause tissue necrosis. CONCLUSIONS: The data support the
contention that sinus vein thrombosis evolves gradually, with major
symptoms occurring only if the thrombus expands from the sinus into
bridging and cortical veins. Collateral venous outflow pathways are thereby
occluded, and local blood flow may become reduced to and below the ischemic
threshold.
ARTICLES
Cerebral blood flow alterations in a rat model of cerebral sinus thrombosis
Department of Neurosurgery, Mainz University School of Medicine, FRG.
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