Moderately elevated intracranial pressure produces greater cross-filling of the anterior communicating artery Journal Article


Authors: Zhang, Y. C.; Young, R. J.; Jones, K.; Koh, E.; Lien, R. J.; Kagetsu, N. J.
Article Title: Moderately elevated intracranial pressure produces greater cross-filling of the anterior communicating artery
Abstract: This study aimed to investigate whether moderately elevated intracranial pressure is associated with greater cross-filling of the anterior communicating artery on diagnostic cerebral angiography. A retrospective study of 12 patients with subarachnoid hemorrhage was performed. Data on sequential cerebral angiograms and clinical data were used to indirectly estimate intracranial pressure (ICP). Cross-filling of the anterior communicating artery (ACom) was recorded according to our scoring system. Our study included 12 patients with mean age 43 ±11 yrs. Six patients demonstrated greater ICP associated with greater cross-filling of the ACom on initial angiogram. One patient had greater ICP with greater cross-filling on follow-up angiogram secondary to infarction and midline shift. Two patients had lower ICP yet greater cross-filling on follow-up angiogram due to higher injection rate and volume. One patient with no change in ICP demonstrated the same degree of cross-filling. A markedly elevated ICP is traditionally associated with no cross-filling across the ACom. We propose a counter-intuitive model in which moderately elevated ICP produces greater cross-filling of the ACom. This diagnostic angiographic finding should make the angiographer consider that the patient has moderately elevated ICP, and facilitate more timely clinical management.
Keywords: adult; clinical article; middle aged; follow up; disease association; retrospective study; scoring system; brain infarction; subarachnoid hemorrhage; brain angiography; intracranial pressure; cerebral angiography; human; male; female; article; cross-filling; iopamidol; angiography device; anterior communicating artery
Journal Title: The Neuroradiology Journal
Volume: 27
Issue: 4
ISSN: 1971-4009
Publisher: Sage Publications Ltd.  
Date Published: 2014-09-01
Start Page: 401
End Page: 408
Language: English
DOI: 10.15274/nrj-2014-10064
PROVIDER: scopus
PMCID: PMC4236865
PUBMED: 25196611
DOI/URL:
Notes: Export Date: 1 December 2014 -- Source: Scopus
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  1. Robert J Young
    208 Young