Doppler Ultrasound Flow Reversal in the Superior Sagittal Sinus to Detect Cerebral Venous Congestion in Vein of Galen Malformation

Vein of Galen malformation (VGAM) is a rare congenital cerebrovascular malformation where increased cerebral venous pressure contributes to brain damage. This study investigated the use of serial cerebral venous Doppler measurements to detect and monitor this increased pressure. Forty-four Doppler ultrasound examinations of the superior sagittal sinus (SSS) and 36 of cortical veins from 7 patients were analyzed. Pre-intervention Doppler flow profiles correlated with disease severity (Spearman r = -0.97, P < .001). Retrograde flow in the SSS was observed in 4 of 7 patients before intervention, and none after embolization. Only patients with significant retrograde flow showed severe venous congestion damage on cerebral MRI. Doppler flow profiles appear useful for noninvasively detecting and monitoring cerebral venous congestion in VGAM.

Bruns Felderhoff-Müser, K Schulz, C Dohna-Schwake, N Schlunz-Hendann, A Feldkamp, T Rosenbaum, U S Schwarz, F Brevis Nuñez, N R Dürr, F Brassel, M Schlunz-Hendann, A Feldkamp, T Rosenbaum, U Felderhoff-Müser, K Schulz, C Dohna-Schwake, N Bruns