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. 2022 Feb;10(3):135.
doi: 10.21037/atm-22-197.

Effect of transverse sinus variation on the clinical outcomes of atherosclerotic anterior circulation infarction

Lianshuang Wu  1   2   3 , Meini Wu  1   2 , Siou Li  2   4 , Dan Xu  1   2 , Yang Jiao  1   2 , Meilingzi Liu  1   2 , Changhao Yin  1   2
Affiliations

Effect of transverse sinus variation on the clinical outcomes of atherosclerotic anterior circulation infarction

Lianshuang Wu et al. Ann Transl Med. 2022 Feb.

Abstract

Background: Hypoplasia of the transverse sinus (TS) is a common anatomical variation. The aim of this study was to investigate the effects of TS variation (i.e., TS hypoplasia) and no variation (i.e., TS symmetry) and their subgroups on the clinical outcomes of patients with atherosclerotic anterior circulation cerebral infarction (CI).

Methods: A total of 75 patients were included in the study and were divided into the no TS variation group and the TS variation group. The TS variation group was further divided into the following subgroups: the TS variation with ipsilateral CI group and the TS variation with contralateral CI group. We retrospectively analyzed the correlations of the endpoint events of patients with large atherosclerotic anterior circulation infarction and TS no variant, and subgroups of TS variants.

Results: We found that the diameter of the ipsilateral IJV in patients with TS variants were significantly smaller than those without TS variants, which was statistically significant (P<0.05). The differences in primary endpoint events, secondary endpoint events, and responsible vessel stenosis were not statistically significant when comparing the TS variant and no TS variant groups, and the TS variant subgroup (P>0.05). We found statistically significant differences in the National Institute of Health stroke scale (NIHSS) and Modified Rankin Scale (mRS) scores after 90 days of CI between the total anterior circulation infarct (TACI) TS variant group, the ipsilateral CI TS variant group, and the partial anterior circulation infarct (PACI) TS hypoplasia group and the ipsilateral CI TS variant group (P<0.05). There was a statistically significant difference (P<0.05) between the TS variant group with TACI, the TS variant group with ipsilateral CI, and the TS no variant group and the TS variant with contralateral CI group when comparing patients' mRS scores after 90 days of CI.

Conclusions: The diameter of the internal jugular vein (IJV) ipsilateral to the TS variant was significantly smaller than that of the TS no variant. Patients with TACI in the TS variant group and one of its subgroups (the TS variant with ipsilateral CI group) had more severe clinical symptoms and a worse prognosis than patients in the same group with PACI.

Keywords: Cerebral infarction (CI); anterior circulation; outcome prognosis; transverse sinus (TS); variation.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-22-197/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
MRV grading of TS variants. TS was classified as 1 of the following 4 grades using MRV imaging according to whether the TS development was symmetrical or not: I) Grade 0: TS bilateral asymmetry ≤10% (A, arrow); (II) Grade 1: TS asymmetry >10% and ≤50% (B, arrow); (III) Grade 2: TS asymmetry >50% (C, arrow); and (IV) Grade 3: TS slenderness or absence (D, arrow). MRV, magnetic resonance venography; TS, transverse sinus.
Figure 2
Figure 2
Primary endpoint events, secondary endpoint events, and TS variants in patients with anterior circulation infarction. CT scan of the head of a 75-year-old male showing a malignant middle cerebral artery infarction with a midline shift of more than 10 mm (A, arrow), and a MRV scan showing ipsilateral TS developmental variation (B, arrow). The CT scan of the head of a 62-year-old male showing a combined hemorrhagic transformation after an anterior circulation infarction (C, arrow), and a MRV scan showing a developmental variation of the contralateral TS (D, arrow). TS, transverse sinus; MRV, magnetic resonance venography.
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