Venous Hypertension and Cerebral Aneurysm Rupture

Abstract

To investigate the correlation between the sinus asymmetry and aneurysm rupture. We retrospectively reviewed all diagnostic and therapeutic conventional angiograms of patients with cerebral aneurysms in our hospital from January 2000 to April 2008. Cases were categorized according to gender, presence or absence of aneurysm rupture, and presence or absence of symmetric dural sinuses. Exclusion criteria included patients with underlying fibromuscular dysplasia, dissecting aneurysms, pseudoaneurysms, and the presence of arteriovenous malformations or fistulas. The venous pressure was measured by MR phase contrast with standard fluid dynamics notation as Poiseuille's Law. A total of 193 cases (131 females and 62 males) were included for Chi-squared analysis, which showed significant difference (p < 0.05) between aneurysm rupture and venous asymmetry in the entire group as well as in females, but not in males. There was an association between side of rupture and side of asymmetry as well as between the size of hemorrhage. Ruptured aneurysm is more frequent at the same side of dominant dural sinus than the side of hypoplasia venous sinus. MRA phase contrast is able to show the venous pressure gradient of asymmetrical dural sinuses. With our preliminary data, we propose that dural sinus asymmetry is associated with aneurysm rupture.