Severe venous congestive encephalopathy secondary to a dialysis arteriovenous graft

Edgar A Samaniego; Kevin J Abrams; Guilherme Dabus; Rosanne Starr; Italo Linfante

doi:10.1136/neurintsurg-2012-010355

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Severe venous congestive encephalopathy secondary to a dialysis arteriovenous graft

Journal article

Peer reviewed

Severe venous congestive encephalopathy secondary to a dialysis arteriovenous graft

Edgar A Samaniego, Kevin J Abrams, Guilherme Dabus, Rosanne Starr and Italo Linfante

Journal of neurointerventional surgery, Vol.5(5), pp.e37-e37

09/01/2013

DOI: 10.1136/neurintsurg-2012-010355

PMID: 22904102

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Abstract

The clinical presentation and imaging of venous congestive encephalopathy (VCE) can mimic several neurological conditions, making the diagnosis challenging. We report a patient with end stage renal disease on dialysis who presented with a right occipital infarction. The patient developed progressive encephalopathy and increased intracranial pressure. Extensive imaging, electroencephalography and serum analysis did not explain the cause of his infarction and progressive neurological deterioration. Finally, cerebral angiography and venography demonstrated severe generalized VCE due to arterial shunting from a right upper extremity arteriovenous graft (AVG) and an occluded right innominate venous trunk. The right arm shunt resulted in severe cerebral venous hypertension due to ipsilateral occlusion of the innominate venous trunk. After the AVG was repaired, the cerebral venous hypertension resolved and the patient returned to baseline.

Venous Insufficiency - etiology

Angiography

Endovascular Procedures - adverse effects

Humans

Middle Aged

Male

Postoperative Complications - therapy

Tomography, X-Ray Computed

Cerebrovascular Disorders - etiology

Hypertension - etiology

Kidney Failure, Chronic - therapy

Magnetic Resonance Imaging

Endovascular Procedures - methods

Vascular Surgical Procedures - methods

Aorta, Thoracic - surgery

Vascular Surgical Procedures - adverse effects

Kidney Failure, Chronic - complications

Renal Dialysis - adverse effects

Arm - surgery

Brain - pathology

Brain - surgery

Blood Vessels - transplantation

Aorta, Thoracic - pathology

Details

Title: Subtitle: Severe venous congestive encephalopathy secondary to a dialysis arteriovenous graft
Creators: Edgar A Samaniego - Department of Neurointerventional Surgery, Baptist Cardiac and Vascular Institute, Miami, FL 33156, USA. edgarsama@gmail.com
Kevin J Abrams
Guilherme Dabus
Rosanne Starr
Italo Linfante
Resource Type: Journal article
Publication Details: Journal of neurointerventional surgery, Vol.5(5), pp.e37-e37
Publisher: England
DOI: 10.1136/neurintsurg-2012-010355
PMID: 22904102
ISSN: 1759-8478
eISSN: 1759-8486
Language: English
Date published: 09/01/2013
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984020601202771

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