Research Paper Volume 11, Issue 23 pp 11073—11083

Clinical and neuroimaging correlates among cohorts of cerebral arteriostenosis, venostenosis and arterio-venous stenosis

Jiayue Ding 1, 2, 3, , Jingwei Guan 1, 2, 3, , Gary Rajah 4, 5, , David Dornbos III 6, , Weili Li 1, 2, 3, , Zhongao Wang 1, 2, 3, , Yuchuan Ding 3, 7, , Xunming Ji 2, 3, 8, , Ran Meng 1, 2, 3, ,

  • 1 Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
  • 2 Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
  • 3 Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
  • 4 Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
  • 5 Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY 14203, USA
  • 6 Department of Neurological Surgery, Semmes-Murphey Clinic and the University of Tennessee Health Science Center, Memphis, TN 38103, USA
  • 7 Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI 48201, USA
  • 8 Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China

received: August 19, 2019 ; accepted: November 18, 2019 ; published: December 2, 2019 ;
How to Cite

Copyright © 2019 Ding et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


The purpose of this study was to discriminate the clinical and imaging correlates of cerebral arterial stenosis (CAS), venous stenosis (CVS) and arterio-venous stenosis (CAVS) in the clinical setting. Patients were classified into three groups: CAS (n = 75), CVS (n=74) and CAVS (n=67). Focal neurological deficits were the prominent presenting symptoms in CAS group, while venous turbulence related symptoms were common in both CVS and CAVS group. Risk factor analysis showed the OR (95%CI) for diabetes, male gender and age in CAS vs. CVS group were 13.67(2.71, 68.85), 6.69(2.39, 18.67) and 1.07(1.03, 1.12) respectively. Male gender, diabetes and age in CAVS vs. CAS groups were 0.27(0.11, 0.63), 0.26(0.10, 0.67) and 1.09(1.04, 1.14) respectively, while age in CAVS vs. CVS group was 1.11(1.07, 1.15). The white matter lesions (WMLs) in CAS group varied in size, with clear boundaries asymmetrically distributed in bilateral hemispheres. CVS-induced WMLs revealed a bilaterally symmetric, cloudy-like appearance. The cerebral perfusion was asymmetrically reduced in CAS but symmetrically reduced in CVS group. The clinical characteristics and neuroimaging presentations were different among patients with CAS, CVS and CAVS. We recommended for aged patients, both arterial and venous imaging should be considered in diagnosis of cerebral stenotic vascular disorders.


CAS: cerebral arterial stenosis; CCCI: chronic cerebral circulation insufficiency; CCSVI: chronic cerebrospinal venous insufficiency; CBF: cerebral blood flow; CBV: cerebral blood volume; CVS: cerebral venous stenosis; IJVS: internal jugular vein stenosis; CVSS: cerebral venous sinus stenosis; MRV: magnetic resonance venography; CTV: computed tomography venography; DSV: digital subtraction venography; CAVS: cerebral arterio-venous stenosis; ICAS: intracranial arterial stenosis; ECAS: extracranial arterial stenosis; NIHSS: National Institute of Health Stroke Scale; ACA: anterior cerebral artery; MCA: middle cerebral artery; PCA: posterior cerebral artery; ICA: internal carotid artery; BA: basilar artery; VA: vertebral artery; IJV: internal jugular vein; MRA: magnetic resonance angiography; CTA: computed tomographic angiography; HR-MRI: high-resolution magnetic resonance imagine; MRI: magnetic resonance image; DWI: diffuse weighted image; FLAIR: fluid attenuated inversion recovery; SPECT: single-photon emission computed tomography; TR: repetition time; TE: echo time; FOV: field of view; TOF: time-of-flight; 99mTc-ECD: technetium-99m ethylene cysteine dimer; 18F-FDG: fluorodeoxyglucose; WMLs: white matter lesions; ROI: region of interest; SD: standard deviation; IQR: interquartile range; MS: multiple sclerosis.