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Clinical study on intracranial venous system lesions and cognitive impairment
Author(s) -
Qian Hairong
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.044512
Subject(s) - medicine , thrombosis , venous thrombosis , neurology , arteriovenous fistula , surgery , radiology , psychiatry
Background Vascular cognitive impairment and Alzheimer's disease are the two major causes of cognitive impairment. Previous studies have focused on the relationship between arterial‐derived diseases and/or small cerebrovascular disease and cognitive impairment, but the cognitive impairment caused by intracranial venous system lesions has received less attention. Intracranial venous system lesions include venous sinus thrombosis, deep vein thrombosis, cortical venous thrombosis, chronic subdural hematoma, dural arteriovenous fistula, venous collagen disease, etc. The pathogenesis and clinical characteristics of cognitive impairment caused by different lesions are different. Method 48 cases of intracranial venous lesions including venous sinus thrombosis, deep vein thrombosis, cortical venous thrombosis and dural arteriovenous fistula admitted to the department of neurology of the sixth medical center of PLA general hospital were retrospectively analyzed. Result 24 cases of venous thrombosis related lesions were male and 14 were female, aged 18‐80 years, including 20 cases of venous sinus thrombosis, 8 cases of deep venous thrombosis, 10 cases of cortical venous thrombosis, with 8 cases of acute cognitive impairment. There were 10 cases of dural arteriovenous fistula, with 6 cases of cognitive impairment. The main clinical manifestations of cognitive impairment were decreased execution speed, forgetfulness, dysarthria, mental changes, urinary incontinence and gait abnormalities. The patients with subcortical white matter, thalamus and other white matter areas involved have more obvious cognitive impairment, while those with mild cortical involvement have relatively less cognitive impairment. The incidence of cognitive impairment of older people was higher than that of younger people, and the incidence was higher in those with significant white matter damage. Conclusion Cognitive impairment caused by intracranial venous system lesions are tightly linked with cerebral white matter lesions in addition to lesions of key parts of brain damage, which may be related to increased intracranial pressure and other factors caused by venous reflux obstacle. Cognitive impairment with venous system lesion deserves more clinical attention and may provide more insights into the causes of dementia.