Venous drainage patterns of perimesencephalic subarachnoid hemorrhage / 中国脑血管病杂志

ABSTRACT

Objective To investigate the relationship between the different deep venous drainage patterns in the brain and the perimesencephalic subarachnoid hemorrhage (PMSAH).Methods From January 2014 to January 2017,the clinical data of 90 patients with subarachnoid hemorrhage (SAH) diagnosed and treated in the Second Affiliated Hospital of Anhui Medical University were analyzed retrospectively.Thirty patients with PMSAH were in a PMSAH group and 60 patients with aneurismal SAH were in a control group.Unilateral cerebral hemisphere venous drainage was divided into type A (normal continuous)the basilar vein had deep middle cerebral vein drainage and was drained into the great cerebral vein of Galen;type B (normal discontinuous)there was discontinuous venous drainage between the basal vein and the anterior uncal vein and the posterior Galen vein;type C (primitive variant)did not drained into great cerebral vein of Galen,perimesencephalic vein was drained into the superior petrosal sinus or basal vein was directly drained into the transverse sinus or straight sinus.The different combinations of bilateral cerebral hemisphere venous drainage were divided into normal type drainage (typeⅠAA),discontinuous type drainage (types ⅡAB or BB),and primitive type drainage (types ⅢAC,BC,or CC).The differences of venous drainage between the two groups were compared.Results In the PMSAH group,both types Ⅰ and Ⅱ drainages accounted for 26.7％ (n=8 in each type) and type Ⅲ accounted for 46.7％ (n=14).In the control group,typeⅠaccounted for 48.3％ (n=29),type Ⅱ accounted for 28.3％ (n=17),and type Ⅲ accounted for 23.3％ (n=14).There were no significant differences in the distribution of three venous drainage patterns between the two groups (χ2=5.804,P=0.055).However,there was significant difference in the types Ⅲ venous drainage between the two groups (χ2=5.081,P=0.024).Conclusion Most of the deep cerebral venous drainage in patients with PMSAH showed basilar venous drainage into the venous sinuses of dura mater,but not to the large cerebral vein drainage,suggesting the way of primitive drainage into the dural sinus was more prone to rupture compared with that of drainage into large cerebral veins.