Association between Transverse Sinus Hypoplasia and Cerebral Venous Thrombosis: A Case-Control Study

J Stroke Cerebrovasc Dis. 2018 Feb;27(2):432-437. doi: 10.1016/j.jstrokecerebrovasdis.2017.09.019. Epub 2017 Oct 31.

Abstract

Background: Hypoplasia of the transverse sinus (TS) is a common anatomical variation. However, the relationship between TS hypoplasia and venous thrombosis has not been studied. We analyzed the hypothesis that TS hypoplasia is a predisposing factor for ipsilateral thrombosis.

Materials and methods: We retrospectively evaluated 20 confirmed cases with isolated TS thrombosis and 43 age- and sex-matched controls. TS thrombosis and hypoplasia were diagnosed using both computed tomography and magnetic resonance venography. Hypoplasia was defined as a TS diameter less than 50% of the cross-sectional diameter of the lumen of the distal superior sagittal sinus and by a bony groove ratio less than 1.02. Univariate analysis was performed to evaluate the association between TS hypoplasia and thrombosis.

Results: There were a total of 45 hypoplastic TS: 31 (49%) left hypoplastic TS (12 (60%) cases vs 19 (44%) controls (P = .24), and 14 (22%) right hypoplastic TS (9 (45%) cases vs 5 (12%) controls (P = .003). TS hypoplasia was more frequently found in cases (n = 18, 90.0%) than in controls (n = 22, 51.2%; relative risk 1.7, confidence interval [CI] 95% 1.3-2.4, P = .003). Hypoplastic TS and ipsilateral TS thrombosis showed a significant association (P = .002 for right and P = .008 for left TS hypoplasia) with relative risk of 3.8 (95% CI 1.3-10) for right and 7.5 (95% CI 1.1-48) for left hypoplasia. No significant association was found between hypoplastic TS and functional outcome at 30- or 90-day follow-up.

Conclusion: TS hypoplasia might be a predisposing factor for ipsilateral TS thrombosis, but not for functional outcome.

Keywords: Cerebral venous thrombosis; lateral sinus thrombosis; stroke; transverse sinus hypoplasia.

MeSH terms

  • Adult
  • Cerebral Angiography / methods
  • Computed Tomography Angiography
  • Female
  • Humans
  • Intracranial Thrombosis / diagnostic imaging
  • Intracranial Thrombosis / etiology*
  • Magnetic Resonance Angiography
  • Male
  • Odds Ratio
  • Phlebography / methods
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Transverse Sinuses / abnormalities*
  • Transverse Sinuses / diagnostic imaging
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / etiology*