Система Orphus

Symptoms of disease - violation of cerebral venous return

The veins of the brain are divided into superficial and deep. Superficial veins, located in the soft brain shell, collect blood from the cortex and white matter, the deep veins of the white matter of the hemispheres, subcortical knots, the walls of the ventricles and vascular plexuses. Vienna Dura are held together with arteries in the thickness of the shell and form a considerable venous network.

All the veins carry blood to collectors of venous blood - venous sines Dura, located between two of its leaves. The main of them: the upper longitudinal sine, passing along the top edge of the big hook process; lower longitudinal sine, located at the bottom of the free edge of a large hook process with cerebellar gallop; cross-sinus - the largest of all, located on the sides of the internal occipital bone thickening; cavernous sine, located on the sides of the Turkish saddle. Between the left and right cavernous sinus cross pass between erectile the sine - front and rear, forming, thus, around the pituitary gland circular sine.

The outflow of blood from the cavity of the skull is through the internal jugular, partly through the vertebral vein and envoy - venous graduates, located inside of the flat bones of the skull and connecting venous sinuses Dura with diploic veins and with external veins of his head.

The role of violations of cerebral venous return to the origin, course and clinical definition of vascular diseases of the brain for a long time underestimated. This is due to the complexity of the in vivo assessment of the state of cerebral venous hemodynamics when used with low-resolution traditional methods of registration of venous blood flow in the vessels of the brain and insufficient attention by the researchers of this section.

Venous outflow from the surface of the brain is disrupted in pathological processes in subarachnoid space (arachnoiditis) and thrombosis top sagittal sinus. Venous outflow from the deep structures of the brain has a much smaller contact with the subarachnoid space (only in the tank), than venous outflow from the surface of the brain. At the same time venous outflow from the deep structures of the brain may be broken, with the localization process in the field of the tanks of the brain and pressure.



Which diseases there is violation of cerebral venous return

At violation of the normal outflow of blood from the brain develop a picture of venous stagnation. The reasons for violations of the venous drainage of the brain can be cardiac and pulmonary insufficiency, compression of extracranial veins, internal jugular, unmarked and upper hollow, brain tumors, cranial trauma, venous thrombosis and sinus of the brain, compression of the veins in cranial stenosis and edema of the brain, hanging asphyxia newborns.

Thrombosis of the veins of the brain may occur without previous inflammation (phlebothrombosis) or on the background of inflammation (thrombophlebitis), but their distinction on clinical grounds difficult.

Thrombosis of superficial veins of the brain. For the clinical picture is characterized by the combination of neurological symptoms with signs of inflammation, usually infectious process (increased body temperature, an inflammatory reaction of the blood, and sometimes and cerebrospinal fluid). Almost always the disease begins headache, which is often accompanied by nausea and vomiting. Quite often violated consciousness (sometimes with psychomotor excitement), and on this background arise focal brain symptoms (paresis or paralysis of the extremities, aphasia, focal or General epileptic seizures, etc.). Typical lability focal symptoms, caused by the migration process from one of venous trunk to another. Morphological substrate, the readiness of the above symptoms are hemorrhagic infarction in the gray and white matter of the brain, intracerebral or subarachnoid hemorrhage, ischemia and swelling of the brain. The overwhelming majority of the cases thrombophlebitis surface of the cerebral veins is observed in the postpartum period. It should be borne in mind that in similar cases in the lumbar puncture can be obtained hemorrhagic cerebrospinal fluid.

Thrombosis of deep veins of the brain and a large cerebral vein (the vein of Galen). The clinical picture is of particular weight. Patients are usually in comatose state, pronounced cerebral phenomena, signs of dysfunction stem and subcortical structures, lifetime diagnosis extremely difficult; it is necessary to attach importance to the development of cerebral symptoms on the background of thrombophlebitis of the limbs or inflammatory lesions in the body, for example, in the postpartum period, after the abortion, in case of diseases of the ear and sinusal nose, at various infectious diseases.

Venous thrombosis sines is characterized by a sharp headache, meningeal symptoms, swelling of subcutaneous tissue of the face or scalp, sometimes rising temperature, changes of consciousness (from sopor to coma). In the fundus - stagnation. In the blood - leukocytosis, Cerebrospinal fluid is transparent chrome, sometimes with a small pleocytosis. Focal neurological symptoms corresponds to localization of the affected sinus.

Thrombosis sigmoid transverse sinus occurs most frequently and is a common complication of purulent otitis or mastoiditis. Is characterized by painful and swelling of the soft tissues in the mastoid process, pain while chewing and turning your head in a healthy way. Is usually accompanied by severe septic phenomena. During the transition of the inflammatory process on the jugular there are signs of defeat of the IX, X and XI of the nerves.

The cavernous sinus thrombosis (the most frequent option venous cerebral pathology) is usually the consequence of a septic condition, complicates purulent processes in the region of the face, orbit, ear and paranasal sinuses. On the background of the sharply expressed inflammatory symptoms are clear signs of disturbances of venous outflow: edema periorbitalnah tissues, rising exophthalmos, chemosis, swelling of the eyelids, the stagnation in the fundus sometimes with the development of atrophy of the optic nerves. In the majority of patients occurs outside ophthalmoplegia consequence of the defeat of III, IV, VI cranial nerve, there are ptosis, pupillary disorders, corneal opacity, due to failure of the upper branches of the trigeminal nerve - pain in the area of the eyeball and the forehead, sensitivity disorders in the zone of supraorbital nerve. The cavernous sinus thrombosis can be bilateral, in such cases, the disease is particularly difficult, and the process may extend to related sinuses. There are cases of the cavernous sinus thrombosis with subacute over and cases of aseptic thrombosis, for example, in hypertension and atherosclerosis.

Thrombosis of the upper longitudinal sinus. The clinical picture varies depending on the etiology, the pace of development of thrombosis, localization within the sinus, as well as on the degree of involvement in the process of flowing in his veins. Especially hard occur cases of septic thrombosis. Under tromboze the upper longitudinal sinus observed overflow and tortuosity veins century, the root of the nose, temples, forehead, crown ("head of Medusa") with swelling of the field; often develop nosebleeds, there is tenderness on percussion parasagittal area. Neurological syndrome is the sum of the symptoms of intracranial hypertension, convulsive seizures, often beginning with a foot, sometimes develops lower paraplegia with incontinence of urine or panplegia.

Marantische sinus thrombosis occur when a debilitating diseases, usually in young children and the elderly.

Infectious thrombosis of the cerebral veins and sinuses may be complicated by the purulent meningitis, encephalitis, brain abscesses.



Which doctor should I contact if there is a violation of cerebral venous return

  • Neurologist
  • Infectious disease physician


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